Kraig Martin Patriquin, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LCSW1223 Issued in WY

Practice address

2360 E Pershing Blvd
Cheyenne, WY 82001-5356

Phone

(307) 778-7550

NPI assigned

Jan 22, 2020

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1579651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579651200000",
    "number": "1043840614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1220 CEDAR DR",
            "city": "BERTHOUD",
            "state": "CO",
            "postal_code": "805131018",
            "telephone_number": "719-649-9320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2360 E PERSHING BLVD",
            "city": "CHEYENNE",
            "state": "WY",
            "postal_code": "820015356",
            "telephone_number": "307-778-7550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATRIQUIN",
        "first_name": "KRAIG",
        "middle_name": "MARTIN",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-01-22",
        "last_updated": "2020-01-22",
        "certification_date": "2020-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "WY",
            "license": "LCSW1223",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ty Parsons, DPT
• Nicole Paschis, OTR
• Pass, Inc. (Professional Advisory & Strategy Services, Inc.
• Anisha A Patel, PHARMACIST
• Patriarch Health Care, LLC
• Bonnie V Patterson, BSW
• Darrallynn Sue Patterson, RN
• Diana Faye Ramos Patterson
• James Victor Patterson, M.A., M.DIV, LMFT
• Julia Renee Patton

• Clinical Social Worker in Cheyenne, WY
• Providers in Cheyenne, WY by specialty
• Clinical Social Worker in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.