Provider Demographics
NPI:1518164292
Name:BOCK, PATRICIA S (LCAS, LCSW)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:S
Last Name:BOCK
Suffix:
Gender:F
Credentials:LCAS, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1418
Mailing Address - Street 2:
Mailing Address - City:CLAYTON
Mailing Address - State:NC
Mailing Address - Zip Code:27528-1418
Mailing Address - Country:US
Mailing Address - Phone:919-585-2069
Mailing Address - Fax:919-585-2075
Practice Address - Street 1:9933 US 70 BUSINESS HWY W
Practice Address - Street 2:
Practice Address - City:CLAYTON
Practice Address - State:NC
Practice Address - Zip Code:27520-2113
Practice Address - Country:US
Practice Address - Phone:919-585-2069
Practice Address - Fax:919-585-2075
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-27
Last Update Date:2015-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)