Provider Demographics
NPI:1316830037
Name:PATTERSON, KASEY JANE (APC)
Entity type:Individual
Prefix:
First Name:KASEY
Middle Name:JANE
Last Name:PATTERSON
Suffix:
Gender:F
Credentials:APC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:480 OLD CANTON RD APT K
Mailing Address - Street 2:
Mailing Address - City:BALL GROUND
Mailing Address - State:GA
Mailing Address - Zip Code:30107-2943
Mailing Address - Country:US
Mailing Address - Phone:470-274-8774
Mailing Address - Fax:
Practice Address - Street 1:480 OLD CANTON RD APT K
Practice Address - Street 2:
Practice Address - City:BALL GROUND
Practice Address - State:GA
Practice Address - Zip Code:30107-2943
Practice Address - Country:US
Practice Address - Phone:470-264-8774
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-02
Last Update Date:2025-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health