MEDICARE: MR. J. PATRICK LINCOLN LCSW, LPA, LPC, LMFT

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	10092	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	00540K	OTHER	TX	BCBS PROVIDER NUMBER

General Provider Information

NPI Number	:	1356413488
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. J. PATRICK LINCOLN LCSW, LPA, LPC, LMFT

Provider Business Mailing Address
First Line	:	6800 PARK TEN BLVD
Second Line	:	SUITE 298 WEST
City	:	SAN ANTONIO
State	:	TX
Zip	:	78213-4211
Country	:	US
Telephone Number	:	210-737-2039
Fax Number	:	210-737-1396

Provider Business Practice Location Address
First Line	:	6800 PARK TEN BLVD
Second Line	:	SUITE 298 WEST
City	:	SAN ANTONIO
State	:	TX
Zip	:	78213-4211
Country	:	US
Telephone Number	:	210-737-2039
Fax Number	:	210-737-1396

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

Provider Enumeration Date	:	11/14/2006
Last Update Date	:	07/08/2007

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Directions to “ MR. J. PATRICK LINCOLN LCSW, LPA, LPC, LMFT” Practice Location

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