Provider Demographics
NPI:1366153462
Name:PENCE, PATTI JANA (LPC)
Entity type:Individual
Prefix:MS
First Name:PATTI
Middle Name:JANA
Last Name:PENCE
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 W RACE AVE STE 6
Mailing Address - Street 2:
Mailing Address - City:SEARCY
Mailing Address - State:AR
Mailing Address - Zip Code:72143-4237
Mailing Address - Country:US
Mailing Address - Phone:501-593-1250
Mailing Address - Fax:
Practice Address - Street 1:120 W RACE AVE STE 1
Practice Address - Street 2:
Practice Address - City:SEARCY
Practice Address - State:AR
Practice Address - Zip Code:72143-4237
Practice Address - Country:US
Practice Address - Phone:501-593-1250
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-09
Last Update Date:2025-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA2210013101Y00000X
ARP2502020101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor