Provider Demographics
NPI:1073658951
Name:SARGENT, PAT F (EDD, LPCC)
Entity type:Individual
Prefix:
First Name:PAT
Middle Name:F
Last Name:SARGENT
Suffix:
Gender:F
Credentials:EDD, LPCC
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 981
Mailing Address - Street 2:
Mailing Address - City:TAOS
Mailing Address - State:NM
Mailing Address - Zip Code:87571-0981
Mailing Address - Country:US
Mailing Address - Phone:505-758-8123
Mailing Address - Fax:505-758-8123
Practice Address - Street 1:1407 SHARP STREET
Practice Address - Street 2:
Practice Address - City:TAOS
Practice Address - State:NM
Practice Address - Zip Code:87571
Practice Address - Country:US
Practice Address - Phone:505-758-8123
Practice Address - Fax:505-758-8123
Is Sole Proprietor?:No
Enumeration Date:2007-02-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM0854101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional