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General NPI Number Information
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NPI Number | 1467610881
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Entity Type | Individual
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Provider Name | PATRICK WILLIAM CLEVELAND LPC
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Gender | Male
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Dates
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Enumeration Date | 06/02/2008
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Last Update Date | 02/03/2023
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Provider Practice Location Address
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Address Line | 1738 WYNKOOP ST STE 303
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City | DENVER
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State | CO
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Zip | 80202-1000
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Country | US
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Telephone | 517-444-0476
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1769
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City | EUNICE
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State | NM
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Zip | 88231-1769
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Country | US
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Telephone | 517-444-0476
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 6401007845
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 469
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License Number State | CO
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Taxonomy #3
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 1797
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License Number State | CO
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