Provider Demographics
NPI:1588407365
Name:ALBERT, PATTY JEAN (LPC, LTT)
Entity type:Individual
Prefix:MRS
First Name:PATTY
Middle Name:JEAN
Last Name:ALBERT
Suffix:
Gender:F
Credentials:LPC, LTT
Other - Prefix:MRS
Other - First Name:PATTY
Other - Middle Name:JEAN
Other - Last Name:ALBERT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CERTIFIED COUNSELOR
Mailing Address - Street 1:5300 MCCOY RD
Mailing Address - Street 2:
Mailing Address - City:BLACKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24060-0870
Mailing Address - Country:US
Mailing Address - Phone:812-272-2251
Mailing Address - Fax:
Practice Address - Street 1:201 LUCAS DR
Practice Address - Street 2:
Practice Address - City:BLACKSBURG
Practice Address - State:VA
Practice Address - Zip Code:24060-7214
Practice Address - Country:US
Practice Address - Phone:812-272-2251
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-18
Last Update Date:2024-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA11478128101YP1600X
VA92-1724879101YP1600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral