Provider Demographics
NPI:1992593180
Name:MACLEOD, PATRICK (LMHC)
Entity type:Individual
Prefix:MR
First Name:PATRICK
Middle Name:
Last Name:MACLEOD
Suffix:
Gender:
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 4TH ST UNIT 1
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:MA
Mailing Address - Zip Code:02155-5120
Mailing Address - Country:US
Mailing Address - Phone:401-932-8150
Mailing Address - Fax:
Practice Address - Street 1:18 4TH ST UNIT 1
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:MA
Practice Address - Zip Code:02155-5120
Practice Address - Country:US
Practice Address - Phone:401-932-8150
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-28
Last Update Date:2025-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MALMHC10001458101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health