The Patton Practice

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

1804 Issued in NC

Legal business name

THE PATTON PRACTICE

Practice address

1108 Grecade St
Suite 203
Greensboro, NC 27408-8729

Phone

(336) 663-8802

Fax

(336) 663-8805

NPI assigned

Jul 20, 2015

Organization subpart

No

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

Authorized official

Name

Theresa Ann Kennedy Patton, LCAS, CCS

Title

Owner

Phone

(336) 663-8802

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1437350400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1437350400000",
    "number": "1285019240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1108 GRECADE ST",
            "address_2": "SUITE 203",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274088729",
            "telephone_number": "336-663-8802",
            "fax_number": "336-663-8805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1108 GRECADE ST",
            "address_2": "SUITE 203",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274088729",
            "telephone_number": "336-663-8802",
            "fax_number": "336-663-8805"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE PATTON PRACTICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-20",
        "last_updated": "2015-07-20",
        "status": "A",
        "authorized_official_last_name": "KENNEDY PATTON",
        "authorized_official_first_name": "THERESA",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "336-663-8802",
        "authorized_official_credential": "LCAS, CCS"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": "1804",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD NC",
            "identifier": "1114210721",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Addiction (Substance Use Disorder) Counselor in Greensboro, NC
• Providers in Greensboro, NC by specialty
• Addiction (Substance Use Disorder) Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2015; 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.