Patterson, Glenroy Patrick

Patterson, Glenroy Patrick is an individual health care provider with primary practice located at 72 Birchwood Rd , East Hartford CT 06118-1702. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Behavioral Analyst. Behavioral Health & Social Service Providers / Behavioral Analyst is his primary health care specialty. Patterson, Glenroy Patrick can be contacted via phone (860) 206-9884.

Contact Information

Primary practice address
72 Birchwood Rd East Hartford CT 06118-1702
Phone: (860) 206-9884
Fax: (860) 812-2399
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X
Behavioral Health & Social Service Providers / Behavioral Analyst 103K00000X 1-12-11741

Profile Details

NPI number 1063754653
LBN Legal business name Patterson, Glenroy Patrick
Credentials BCBA
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 21st, 2013
Last updated Feb 22nd, 2019 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1063754653 NPPES
Massachusetts MEDICAID 110026265

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