Provider Demographics
NPI:1386414407
Name:PATTERSON, KORYNN CHEYANNE (LMSW)
Entity type:Individual
Prefix:
First Name:KORYNN
Middle Name:CHEYANNE
Last Name:PATTERSON
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9103 AQUA LYNN CT
Mailing Address - Street 2:
Mailing Address - City:FORT WASHINGTON
Mailing Address - State:MD
Mailing Address - Zip Code:20744-4859
Mailing Address - Country:US
Mailing Address - Phone:240-722-2128
Mailing Address - Fax:
Practice Address - Street 1:9103 AQUA LYNN CT
Practice Address - Street 2:
Practice Address - City:FORT WASHINGTON
Practice Address - State:MD
Practice Address - Zip Code:20744-4859
Practice Address - Country:US
Practice Address - Phone:240-722-2128
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-09
Last Update Date:2024-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD28230104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker