Organization
THE PATTON PRACTICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THERESA ANN KENNEDY PATTON LCAS, CCS (OWNER)
(336) 663-8802
Entity
Organization
Contact information
Practice address
1108 GRECADE ST, SUITE 203, GREENSBORO, NC 27408-8729
(336) 663-8802
(336) 663-8805
Mailing address
1108 GRECADE ST, SUITE 203, GREENSBORO, NC 27408-8729
(336) 663-8802
(336) 663-8805
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1804
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1114210721
BLUE CROSS BLUE SHIELD NC
NC
Enumeration date
07/20/2015
Last updated
07/20/2015
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