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Ms. Theresa Ann Kennedy Patton, LCPCCRCLCACLISAC
Addiction (Substance Use Disorder) Counselor in Washington, Illinois
NPI 1114210721

Theresa Ann Kennedy Patton is an Addiction (Substance Use Disorder) Counselor based in Washington, IL and is specialized in Addiction (Substance Use Disorder). Theresa Ann Kennedy Patton practices in Washington, IL and has the professional credentials of LCPCCRCLCACLISAC. The NPI Number for Theresa Ann Kennedy Patton is 1114210721 and holds a License No. 15216 (Illinois).

The current practice location address for Theresa Ann Kennedy Patton is 617 Stephanie Ct, Washington, IL and can be reached out via phone at 317-799-4343 and via fax at 317-643-8989.

Location: 617 Stephanie Ct, Washington, IL, 61571-9279
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1114210721
Provider Name
Theresa Ann Kennedy Patton
Credential
LCPCCRCLCACLISAC
Provider Entity Type
Individual
Gender
Female
Address
617 Stephanie Ct, Washington, IL, 61571-9279
Phone Number
317-799-4343
Fax Number
317-643-8989
Provider Enumeration Date
05/16/2011
Last Update Date
08/17/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
1114210721 05 IL
1114210721 01 IL BLUE CROSS BLUE SHIELD
institution
Provider Business Practice Location Address Details
Address
617 Stephanie Ct
City
Washington
State
Illinois
Zip
61571-9279
Phone Number
317-799-4343
Fax Number
317-643-8989
person
Provider Business Mailing Address Details
Address
617 Stephanie Ct
City
Washington
State
Illinois
Zip
61571-9279
Phone Number
317-799-4343
Fax Number
317-643-8989
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Addiction (Substance Use Disorder)
Taxonomy
101YA0400X
License No.
16405 (Texas)
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
101YM0800X
License No.
87001357A (Indiana)
Definition
Definition to come...
person
Provider's Taxonomy Details 3
Type
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Classification
Rehabilitation Counselor
Speciality
-
Taxonomy
225C00000X
License No.
15216 (Arizona)
Definition
An individual trained and educated in a systematic process of assisting persons with physical, mental, developmental, cognitive, and emotional disabilities to achieve their personal, career, and independent living goals assessment and appraisal, diagnosis and treatment planning, career (vocational) counseling, individual and group counseling interventions for adjustments to the medical and psychosocial impact of disability, case management, program evaluation and research, job analysis and placement counseling, and consultation on rehabilitation resources and technology. Certification generally requires a Master's degree with specialized courses in rehabilitation processes and technology.
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