Provider Demographics
NPI:1962565465
Name:CODY, PATRICIA (MA)
Entity type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:
Last Name:CODY
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:981 STATE ROAD 46 EAST, SUITE D
Mailing Address - Street 2:
Mailing Address - City:BATESVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47006-1253
Mailing Address - Country:US
Mailing Address - Phone:812-933-1820
Mailing Address - Fax:812-932-1820
Practice Address - Street 1:981 STATE ROAD 46 EAST, SUITE D
Practice Address - Street 2:
Practice Address - City:BATESVILLE
Practice Address - State:IN
Practice Address - Zip Code:47006-1253
Practice Address - Country:US
Practice Address - Phone:812-933-1820
Practice Address - Fax:812-932-1820
Is Sole Proprietor?:No
Enumeration Date:2006-12-18
Last Update Date:2009-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
000000143220OtherANTHEM PROVIDER NUMBER