Provider Demographics
NPI:1669515961
Name:PATTEN, JOHN E (LPC)
Entity type:Individual
Prefix:MR
First Name:JOHN
Middle Name:E
Last Name:PATTEN
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:212 W NORTH LAKESHORE DR
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:GA
Mailing Address - Zip Code:31635-1153
Mailing Address - Country:US
Mailing Address - Phone:229-482-1109
Mailing Address - Fax:229-482-2843
Practice Address - Street 1:404 LOVE AVE
Practice Address - Street 2:
Practice Address - City:TIFTON
Practice Address - State:GA
Practice Address - Zip Code:31794-4404
Practice Address - Country:US
Practice Address - Phone:229-388-9190
Practice Address - Fax:229-387-0523
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAGA1494101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health