MR. RUSSELL JERMAIN PATTERSON MA NPI 1689375412

NPI Information

NPI: 1689375412
Provider Name: MR. RUSSELL JERMAIN PATTERSON, MA
Classification: Counselor - 101Y00000X
Entity Type: Individual
Address:
124 S MAIN ST STE 218
JONESBORO, GA
ZIP 30236
Phone: (678) 215-8705
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MR. Russell Jermain Patterson, MA is a counselor in Jonesboro, GA. The provider is a provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification. MR. Russell Jermain Patterson, MA NPI is 1689375412. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

124 S MAIN ST STE 218
JONESBORO, GA
ZIP 30236-599
Phone: (678) 215-8705

The enumeration date for this NPI number is 3/17/2023 and was last updated on 3/17/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101Y00000X	Counselor				Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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