Basic Information
| Provider Information | |||||||||
| NPI: | 1609168053 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | PATTERSON | ||||||||
| FirstName: | JAMES | ||||||||
| MiddleName: | VICTOR | ||||||||
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| Credential: | M.A., M.DIV, LMFT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 314 N LAST CHANCE GULCH | ||||||||
| Address2: | SUITE 306 | ||||||||
| City: | HELENA | ||||||||
| State: | MT | ||||||||
| PostalCode: | 596015012 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4066866463 | ||||||||
| FaxNumber: | 3074264133 | ||||||||
| Practice Location | |||||||||
| Address1: | 516 E 18TH ST | ||||||||
| Address2: | |||||||||
| City: | CHEYENNE | ||||||||
| State: | WY | ||||||||
| PostalCode: | 820014618 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3075090772 | ||||||||
| FaxNumber: | 3074264133 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/04/2011 | ||||||||
| LastUpdateDate: | 06/06/2013 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 106H00000X | LMFT-168 | WY | Y | Behavioral Health & Social Service Providers | Marriage & Family Therapist | 106H00000X | SWP-LMFT-LIC-4524 | MT | N | Behavioral Health & Social Service Providers | Marriage & Family Therapist | 101YP2500X | SWP-LCPC-LIC-4541 | MT | N | Behavioral Health & Social Service Providers | Counselor | Professional |
No ID Information.