Provider Demographics
NPI:1710013305
Name:PATTEN, CAROLE JOANN (LCSW)
Entity type:Individual
Prefix:
First Name:CAROLE
Middle Name:JOANN
Last Name:PATTEN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2159 N VANCOUVER AVE
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74127-2218
Mailing Address - Country:US
Mailing Address - Phone:405-627-8106
Mailing Address - Fax:
Practice Address - Street 1:2159 N VANCOUVER AVE
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74127-2218
Practice Address - Country:US
Practice Address - Phone:405-627-8106
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-26
Last Update Date:2013-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK04341041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical