Active NPI
Ken Patriquin, MS, LPC, CAADC
- Mental Health Counselor
- Caro, MI
National Provider Identifier
1386690527
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 6401009582
- Practice address
- 651 N State St
Caro, MI 48723-1543 - Phone
- (989) 673-5700
- Fax
- (989) 672-2555
- NPI assigned
- May 26, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 6401009582 | MI | Primary |
Addresses
Primary practice location
651 N State St
Caro, MI 48723-1543
Mailing address
443 N State St
Caro, MI 48723-1539
Phone (989) 672-6160
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6401009582 | MI | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1148601600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1327536000000",
"number": "1386690527",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "443 N STATE ST",
"city": "CARO",
"state": "MI",
"postal_code": "487231539",
"telephone_number": "989-672-6160",
"fax_number": "989-672-5649"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "651 N STATE ST",
"city": "CARO",
"state": "MI",
"postal_code": "487231543",
"telephone_number": "989-673-5700",
"fax_number": "989-672-2555"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PATRIQUIN",
"first_name": "KEN",
"credential": "MS, LPC, CAADC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-26",
"last_updated": "2012-01-26",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "MI",
"license": "6401009582",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Caro, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.