Provider Demographics
NPI:1366187601
Name:PATTON, SARAH ANNE (LPC)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:ANNE
Last Name:PATTON
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:PO BOX 13442
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:WY
Mailing Address - Zip Code:83002-3442
Mailing Address - Country:US
Mailing Address - Phone:478-973-2904
Mailing Address - Fax:
Practice Address - Street 1:808 POWDERHORN LN APT D
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:WY
Practice Address - Zip Code:83001-8009
Practice Address - Country:US
Practice Address - Phone:478-973-2904
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-02
Last Update Date:2024-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC012484101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health