Kenneth R. Pataky, MS, LCMHC, LMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

10249 Issued in NC

Practice address

4058 Cobbler CT
Jamestown, NC 27282-7788

Phone

(336) 454-0426

Fax

(336) 450-2644

NPI assigned

Jun 19, 2013

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1371600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638835200000",
    "number": "1609215045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4058 COBBLER CT",
            "city": "JAMESTOWN",
            "state": "NC",
            "postal_code": "272827788",
            "telephone_number": "336-454-0426",
            "fax_number": "336-450-2644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4058 COBBLER CT",
            "city": "JAMESTOWN",
            "state": "NC",
            "postal_code": "272827788",
            "telephone_number": "336-454-0426",
            "fax_number": "336-450-2644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATAKY",
        "first_name": "KENNETH",
        "middle_name": "R.",
        "name_prefix": "Mr.",
        "credential": "MS, LCMHC, LMHC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-06-19",
        "last_updated": "2021-12-07",
        "certification_date": "2021-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NC",
            "license": "10249",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "HI",
            "license": "MHC-662",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "10249",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "HI",
            "license": "MHC-662",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dirk Nuttle, LPCA, LCAS-A, CRC
• Lauren Elizabeth O'Connor, PA-C
• Valosha Ashleigh Odom, MBA
• Clara Olaitan Ogunsan, PHARMD
• Parakletos Services Incorporated
• Donald P. Patterson, PH.D.
• Jesse Perry
• Rudolf Harald Wilhelm Petrini, LCMHC
• Piedmont Counseling and Development
• Piedmont Therapy and Wellness, PLLC

• Mental Health Counselor in Jamestown, NC
• Providers in Jamestown, NC by specialty
• Mental Health Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2021; 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.