Carol L Patrick, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

3947 Issued in OH

Practice address

1037 W Market St
Lima, OH 45805-2729

Phone

(419) 222-5077

Fax

(419) 228-5343

NPI assigned

Jun 16, 2005

Reactivated

Mar 27, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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  • NPI 1639894041

  Clinical

  NPD (past)

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

{
    "created_epoch": "1118880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1679578561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1037 W MARKET ST",
            "city": "LIMA",
            "state": "OH",
            "postal_code": "458052729",
            "telephone_number": "419-222-5077",
            "fax_number": "419-228-5343"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1037 W MARKET ST",
            "city": "LIMA",
            "state": "OH",
            "postal_code": "458052729",
            "telephone_number": "419-222-5077",
            "fax_number": "419-228-5343"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATRICK",
        "first_name": "CAROL",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-06-16",
        "last_updated": "2007-07-08",
        "deactivation_date": "2006-03-18",
        "reactivation_date": "2006-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "OH",
            "license": "3947",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0691121",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Violet R Patel
• Pathology Laboratory Medicine Associates of Lima Inc
• Lauren Paton, PHARMD
• William Paton, PHARMD
• Manuel Florent Julian Patricio, M.D.
• James J Patterson, M.D
• Amber Lea Patton, D.O.
• Joe A Patton, DDS
• Elizabeth Ashley Paulin, MD
• Mark Lewis Paulus

• Clinical Psychologist in Lima, OH
• Providers in Lima, OH by specialty
• Clinical Psychologist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.