Provider Demographics
NPI:1932247616
Name:PATTERSON, JACQUELYN WELCH (MSW)
Entity type:Individual
Prefix:
First Name:JACQUELYN
Middle Name:WELCH
Last Name:PATTERSON
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:604 DAVIS CIR SW
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35801-5014
Mailing Address - Country:US
Mailing Address - Phone:256-289-3420
Mailing Address - Fax:
Practice Address - Street 1:604 DAVIS CIR SW
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-5014
Practice Address - Country:US
Practice Address - Phone:256-289-3420
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-02
Last Update Date:2025-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL5821C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL330000014Medicaid