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General NPI Number Information
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NPI Number | 1992235576
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Entity Type | Individual
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Provider Name | EDITH H PATAGUNDI LPC
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Gender | Female
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Dates
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Enumeration Date | 06/15/2017
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Last Update Date | 10/01/2025
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Provider Practice Location Address
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Address Line | 900 W SOUTH BOUNDARY ST BLDG 6
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City | PERRYSBURG
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State | OH
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Zip | 43551-5235
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Country | US
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Telephone | 614-339-0806
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Fax |
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Provider Business Mailing Address
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Address Line | 950 S 1ST ST
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City | LOUISVILLE
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State | KY
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Zip | 40203-2202
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Country | US
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Telephone | 502-585-9444
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Fax | 502-585-9466
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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 | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 221700000X
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Taxonomy Name | Art Therapist
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License Number | 262144
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License Number State | KY
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Taxonomy #3
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 173535
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License Number State | KY
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Taxonomy #4
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | C.2103819
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License Number State | OH
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