Desirae Patrick
Individual provider Active NPI Mental Health Counselor · Mount Carroll, IL
NPI 1154798684 · NPPES record last updated Sep 1, 2015
Key facts
- NPI
- 1154798684
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- Practice address
- 1126 Healthcare Dr
Mount Carroll, IL 61053-1469 - Phone
- (815) 244-4200
- NPI assigned
- Sep 1, 2015
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | Yes |
Addresses
Primary practice location
1126 Healthcare Dr
Mount Carroll, IL 61053-1469
Mailing address
1126 Healthcare Dr
Mount Carroll, IL 61053-1469
Phone (815) 244-4200
Other providers in Mount Carroll, IL
- Paula Kay Maxwell
- Jody L McWhorter
- Jennifer Miller
- Mount Carroll Fire Protection District
- Tammy Ann Olson
- Pharmacy Center Inc.
- Katelyn Renee Phillips
- Michelle L Polizzi
- Melisa M Pope-Reedy
- Kirby A Price
All providers in Mount Carroll, IL · Mental Health Counselor in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 1, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.