Provider Demographics
NPI:1730445693
Name:HANLEY, PATRICIA T (LPCD)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:T
Last Name:HANLEY
Suffix:
Gender:F
Credentials:LPCD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:720 OAK ST
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NC
Mailing Address - Zip Code:27536-3967
Mailing Address - Country:US
Mailing Address - Phone:252-657-8779
Mailing Address - Fax:
Practice Address - Street 1:512 FORBES AVE
Practice Address - Street 2:
Practice Address - City:CARLISLE
Practice Address - State:PA
Practice Address - Zip Code:17013-5112
Practice Address - Country:US
Practice Address - Phone:252-657-8779
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-05
Last Update Date:2012-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC7949101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional