Provider Demographics
NPI:1588360275
Name:ULLMAN, PATRICIA JEAN (LGPC)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:JEAN
Last Name:ULLMAN
Suffix:
Gender:F
Credentials:LGPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5225 POOKS HILL RD APT 1217S
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20814-6722
Mailing Address - Country:US
Mailing Address - Phone:301-828-5946
Mailing Address - Fax:
Practice Address - Street 1:1 W CHURCH ST
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21701-5991
Practice Address - Country:US
Practice Address - Phone:301-818-1145
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-03
Last Update Date:2023-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLGP13417101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health