Provider Demographics
NPI:1386070852
Name:PATTON, REGINA M (LPCC)
Entity type:Individual
Prefix:
First Name:REGINA
Middle Name:M
Last Name:PATTON
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11161 KENWOOD RD
Mailing Address - Street 2:
Mailing Address - City:BLUE ASH
Mailing Address - State:OH
Mailing Address - Zip Code:45242-1817
Mailing Address - Country:US
Mailing Address - Phone:513-602-5280
Mailing Address - Fax:
Practice Address - Street 1:11161 KENWOOD RD
Practice Address - Street 2:
Practice Address - City:BLUE ASH
Practice Address - State:OH
Practice Address - Zip Code:45242-1817
Practice Address - Country:US
Practice Address - Phone:513-769-4600
Practice Address - Fax:513-769-0304
Is Sole Proprietor?:No
Enumeration Date:2013-09-17
Last Update Date:2021-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE.1700035101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0244990Medicaid