Provider Demographics
NPI:1891977385
Name:UPCHURCH, PATRICIA STARR (PC)
Entity type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:STARR
Last Name:UPCHURCH
Suffix:
Gender:F
Credentials:PC
Other - Prefix:
Other - First Name:PATRICIA
Other - Middle Name:STARR
Other - Last Name:SADURSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PC
Mailing Address - Street 1:1592 GRANVILLE PIKE
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:OH
Mailing Address - Zip Code:43130-1076
Mailing Address - Country:US
Mailing Address - Phone:740-687-0835
Mailing Address - Fax:740-687-9391
Practice Address - Street 1:1592 GRANVILLE PIKE
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:OH
Practice Address - Zip Code:43130-1076
Practice Address - Country:US
Practice Address - Phone:740-687-0835
Practice Address - Fax:740-687-9391
Is Sole Proprietor?:No
Enumeration Date:2007-11-27
Last Update Date:2007-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC.0602243101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health