Active NPI
Dwight D Patrick, LPC
- Professional Counselor
- Addison, TX
National Provider Identifier
1467896803
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 70023
- Practice address
- 16901 Dallas Pkwy
Addison, TX 75001-5226 - Phone
- (972) 372-4982
- NPI assigned
- Apr 27, 2013
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 70023 | TX | Primary |
Addresses
Primary practice location
16901 Dallas Pkwy
Addison, TX 75001-5226
Mailing address
806 Saint Andrews CT
Garland, TX 75043-5626
Phone (972) 372-4982
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 70023 | Other | TX | LPC LICENSE NUMBER |
Other names 1
- Mr. Ike Patrick
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Mar 12, 2025 through Mar 12, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 70023 | TX | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1367020800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1524528000000",
"number": "1467896803",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "806 SAINT ANDREWS CT",
"city": "GARLAND",
"state": "TX",
"postal_code": "750435626",
"telephone_number": "972-372-4982",
"fax_number": "972-387-3987"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16901 DALLAS PKWY",
"city": "ADDISON",
"state": "TX",
"postal_code": "750015226",
"telephone_number": "972-372-4982"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PATRICK",
"first_name": "DWIGHT",
"middle_name": "D",
"name_prefix": "Mr.",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-04-27",
"last_updated": "2018-04-24",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "TX",
"license": "70023",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LPC LICENSE NUMBER",
"identifier": "70023",
"state": "TX"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "IKE",
"last_name": "PATRICK",
"prefix": "MR.",
"credential": "LPC INTERN",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Addison, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2018; 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.