Patricia Clark, LPCC
Individual provider Active NPI Counselor · Batavia, OH
NPI 1508210394 · NPPES record last updated Apr 18, 2016
Key facts
- NPI
- 1508210394
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Counselor 101Y00000X
- License
- E.0800303 (OH)
- Practice address
- 1088 Wasserman Way Ste C
Batavia, OH 45103-1974 - Phone
- (513) 735-8100
- NPI assigned
- Apr 18, 2016
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| E.0800303 | OH | MD | Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Clermont Recovery Center, Inc. | Past | Accepting new patients | |
| Clermont Recovery Center, Inc. | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | E.0800303 | OH | Yes |
Addresses
Primary practice location
1088 Wasserman Way Ste C
Batavia, OH 45103-1974
Mailing address
2808 Laurel PT Isabel Rd
Moscow, OH 45153-9756
Phone (513) 519-4429
Other providers in Batavia, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 18, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.