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General NPI Number Information
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NPI Number | 1811803562
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Entity Type | Organization
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Legal Business Name | BIRDS THAT SOAR COUNSELING & DEVELOPMENT, LLC
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Dates
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Enumeration Date | 08/21/2026
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Last Update Date | 08/21/2026
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Provider Practice Location Address
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Address Line | 5012 PEARSON ST
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City | MATTESON
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State | IL
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Zip | 60443-3110
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Country | US
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Telephone | 708-941-1052
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Fax |
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Provider Business Mailing Address
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Address Line | 20015 N LAGRANGE RD # 1016
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City | FRANKFORT
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State | IL
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Zip | 60423-3104
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Country | US
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Telephone | 708-941-1052
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. PATRICE PATTON-CAMPBELL
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Credential | LCPC, NCC, CCTP
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Telephone | 708-941-1052
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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 |
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License Number State |
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