Telicia Patrick

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6851110150 Issued in MI

Practice address

411 W Lake Lansing Rd Ste C125
East Lansing, MI 48823-8485

Phone

(517) 215-5217

Fax

(517) 338-8022

NPI assigned

Aug 25, 2021

Last updated

Aug 25, 2021By the provider in NPPES

Sex

Female

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": "1629849600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629849600000",
    "number": "1255008470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "411 W LAKE LANSING RD STE C125",
            "city": "EAST LANSING",
            "state": "MI",
            "postal_code": "488238485",
            "telephone_number": "517-215-5217",
            "fax_number": "517-338-8022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 W LAKE LANSING RD STE C125",
            "city": "EAST LANSING",
            "state": "MI",
            "postal_code": "488238485",
            "telephone_number": "517-215-5217",
            "fax_number": "517-338-8022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATRICK",
        "first_name": "TELICIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-08-25",
        "last_updated": "2021-08-25",
        "certification_date": "2021-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6851110150",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Patrick Counseling Services LLC
• Patrick Psychotherapy LLC
• Kali Patrick, R.PH
• Megan Patrick, D.C.
• Melissa Rose Patrick, LMSW
• Pats Psychological Services LLC
• Mark Anthony Pattee, COTA/L
• Meghan Kristi Patterson, LMT
• Shannon Pavlak
• Michael Pavlik, PHARMD

• Clinical Social Worker in East Lansing, MI
• Providers in East Lansing, MI by specialty
• Clinical Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2021; 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.