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NPI Code Detail

MEDICARE: DR. STARLETTE MARIE PATTERSON-BIDDLE PHD

MEDICARE: DR. STARLETTE MARIE PATTERSON-BIDDLE PHD
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
1101Y00000XCounselor4657-125WI
2101YM0800XMental Health Counselor4657-125WI
3101YP2500XProfessional Counselor4657-125WI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
24657-125OTHERWIWISCONSIN DEPARTMENT OF SAFETY AND PROFESSIONAL SERVICES

General Provider Information

NPI Number : 1689800674
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. STARLETTE MARIE PATTERSON-BIDDLE PHD
Provider Business Mailing Address
First Line : PO BOX 1115
Second Line :
City : MENOMONEE FALLS
State : WI
Zip : 53052-1115
Country : US
Telephone Number : 414-614-7827
Fax Number : 414-435-0543
Provider Business Practice Location Address
First Line : 4025 N 92ND ST
Second Line :
City : MILWAUKEE
State : WI
Zip : 53222-1613
Country : US
Telephone Number : 414-435-1115
Fax Number : 414-435-0543
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/03/2009
Last Update Date : 05/07/2021

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