Provider Demographics
NPI:1417775487
Name:PATTAN, SHIRLEY (LCSW)
Entity type:Individual
Prefix:
First Name:SHIRLEY
Middle Name:
Last Name:PATTAN
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 1:3182 HILL POINT ST
Mailing Address - Street 2:
Mailing Address - City:MINNEOLA
Mailing Address - State:FL
Mailing Address - Zip Code:34715-6860
Mailing Address - Country:US
Mailing Address - Phone:904-477-7436
Mailing Address - Fax:904-477-7436
Practice Address - Street 1:3182 HILL POINT ST
Practice Address - Street 2:
Practice Address - City:MINNEOLA
Practice Address - State:FL
Practice Address - Zip Code:34715-6860
Practice Address - Country:US
Practice Address - Phone:904-477-7436
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-30
Last Update Date:2024-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical