Provider Demographics
NPI:1679754543
Name:PATTON, LEE R (LMHC)
Entity type:Individual
Prefix:MR
First Name:LEE
Middle Name:R
Last Name:PATTON
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12942 EARLY RUN LN
Mailing Address - Street 2:
Mailing Address - City:RIVERVIEW
Mailing Address - State:FL
Mailing Address - Zip Code:33578-3383
Mailing Address - Country:US
Mailing Address - Phone:813-239-7989
Mailing Address - Fax:
Practice Address - Street 1:12942 EARLY RUN LN
Practice Address - Street 2:
Practice Address - City:RIVERVIEW
Practice Address - State:FL
Practice Address - Zip Code:33578-3383
Practice Address - Country:US
Practice Address - Phone:813-239-7989
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-20
Last Update Date:2007-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH8497101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health