Active NPI
Willie T. Patterson, LADC
- Addiction (Substance Use Disorder) Counselor
- Windsor, CT
National Provider Identifier
1659965739
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 1398
- Practice address
- 340 Broad St Ste 204
Windsor, CT 06095-3030 - Phone
- (860) 778-6951
- NPI assigned
- Mar 1, 2021
- 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 |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 1398 | CT | Primary |
Addresses
Primary practice location
340 Broad St Ste 204
Windsor, CT 06095-3030
Mailing address
13 Canterbury St
Manchester, CT 06042-1905
Phone (860) 778-6951
Other practice location 1
13 Canterbury St
Manchester, CT 06042-1905
Phone (860) 778-6951
Other practice location 2
13 Canterbury St
Manchester, CT 06042-1905
Phone (860) 778-6951
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1398 | CT | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Soulutions LLC | Addiction (Substance Use Disorder) | Current | Accepting new patients |
Locations
340 Broad St
Ste 204
Windsor, CT 06095
Phone (860) 378-5614
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1614556800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1615248000000",
"number": "1659965739",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13 CANTERBURY ST",
"city": "MANCHESTER",
"state": "CT",
"postal_code": "060421905",
"telephone_number": "860-778-6951"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "340 BROAD ST STE 204",
"city": "WINDSOR",
"state": "CT",
"postal_code": "060953030",
"telephone_number": "860-778-6951"
}
],
"practiceLocations": [
{
"address_1": "13 Canterbury St",
"address_purpose": "LOCATION",
"city": "Manchester",
"state": "CT",
"postal_code": "060421905",
"country_code": "US",
"telephone_number": "860-778-6951",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "13 Canterbury St",
"address_purpose": "LOCATION",
"city": "Manchester",
"state": "CT",
"postal_code": "060421905",
"country_code": "US",
"telephone_number": "860-778-6951",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "PATTERSON",
"first_name": "WILLIE",
"middle_name": "T.",
"name_prefix": "Mr.",
"credential": "LADC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-03-01",
"last_updated": "2021-03-09",
"certification_date": "2021-03-05",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "CT",
"license": "1398",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Windsor, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 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.