Provider Demographics
NPI:1790561322
Name:PATTERSON, NORMAN WAYNE (LCSW)
Entity type:Individual
Prefix:
First Name:NORMAN
Middle Name:WAYNE
Last Name:PATTERSON
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9600 TWO NOTCH RD STE 5
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29223-1612
Mailing Address - Country:US
Mailing Address - Phone:803-200-2239
Mailing Address - Fax:
Practice Address - Street 1:505 B AVE APT 1
Practice Address - Street 2:
Practice Address - City:WEST COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29169-7560
Practice Address - Country:US
Practice Address - Phone:678-914-9659
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-08
Last Update Date:2025-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MALICSW1275211041C0700X
GACSW0087431041C0700X
SC16492104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical