MEDICARE: PATRICIA SOFIA ARCHILLA-FRATICELLI LCMHCA, NCC

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	A22244	NC

General Provider Information

NPI Number	:	1659210417
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PATRICIA SOFIA ARCHILLA-FRATICELLI LCMHCA, NCC

Provider Business Mailing Address
First Line	:	1117 E MOREHEAD ST STE 200
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28204-2870
Country	:	US
Telephone Number	:	980-220-2223
Fax Number	:

Provider Business Practice Location Address
First Line	:	B11 CALLE CRISANTEMOS
Second Line	:
City	:	CAGUAS
State	:	PR
Zip	:	00727-1259
Country	:	US
Telephone Number	:	939-273-4624
Fax Number	:

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

Provider Enumeration Date	:	03/26/2026
Last Update Date	:	03/26/2026

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