Lauren Olivia Patterson-Siekirk, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY004201 Issued in GA

Practice address

108 S Zetterower Ave
Statesboro, GA 30458-4816

Phone

(912) 231-7279

NPI assigned

May 4, 2020

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

Other names 1

• Lauren Olivia Patterson Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Apr 17, 2024 through Apr 17, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Lauren O. Patterson, Psy.D., L.L.C.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Statesboro, GA
  • NPI 1134906118
  NPD Authorized official

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

{
    "created_epoch": "1588550400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692230400000",
    "number": "1336760164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "209 THORNWOOD CT",
            "city": "STATESBORO",
            "state": "GA",
            "postal_code": "304580296",
            "telephone_number": "912-231-7279"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 S ZETTEROWER AVE",
            "city": "STATESBORO",
            "state": "GA",
            "postal_code": "304584816",
            "telephone_number": "912-231-7279"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "209 Thornwood Ct",
            "address_purpose": "LOCATION",
            "city": "Statesboro",
            "state": "GA",
            "postal_code": "304580296",
            "country_code": "US",
            "telephone_number": "912-231-7279",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PATTERSON-SIEKIRK",
        "first_name": "LAUREN",
        "middle_name": "OLIVIA",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-05-04",
        "last_updated": "2023-08-17",
        "certification_date": "2023-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "GA",
            "license": "PSY004201",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LAUREN",
            "last_name": "PATTERSON",
            "middle_name": "OLIVIA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kashyap Patel, M.D.
• Mital Patel, PHARM. D.
• Rima Umesh Patel
• Suketu J. Patel, DMD, MD
• Ashley Patrick, SLP
• Inga Demetria Paulk- Johnson, LPN
• Clint D Paxson, O.D.
• Mikala Payne
• Jordan William Paynter
• Jessica Pearson

• Clinical Psychologist in Statesboro, GA
• Providers in Statesboro, GA by specialty
• Clinical Psychologist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.