MEDICARE: MR. RICHARD LEWIS PATNAUDE LPCC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	0085791	NM

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1053460808
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. RICHARD LEWIS PATNAUDE LPCC

Provider Business Mailing Address
First Line	:	12056 STATE HIGHWAY 14 N
Second Line	:
City	:	CEDAR CREST
State	:	NM
Zip	:	87008-9405
Country	:	US
Telephone Number	:	505-228-6343
Fax Number	:	505-286-6112

Provider Business Practice Location Address
First Line	:	12126 STATE HIGHWAY 14 N STE E
Second Line	:
City	:	CEDAR CREST
State	:	NM
Zip	:	87008-9406
Country	:	US
Telephone Number	:	505-286-6112
Fax Number	:	505-286-6112

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/10/2007
Last Update Date	:	06/11/2019

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