Alyssa B Patton | Springfield, IL • PECOS Search

Alyssa B Patton

Counselor

Behavioral Health & Social Service Providers

2663 Farragut Dr, Suite A, Springfield, IL 62704-1462

(217) 793-0684 (217) 787-8585

PECOS Enrollment

Based on the most recent information from CMS, provider Alyssa B Patton does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records yesterday at 12:57 PM.

Profile Details

Provider ID
1598192718
Provider Type
Individual
Full Name
Patton, Alyssa B
Title
Mrs.
Credential
LCPC

Gender
Female
Sole Proprietor
Yes
Enumeration Date
10/2/2013
Last Updated
10/16/2013

Contact Information

Practice Location

2663 Farragut Dr, Suite A, Springfield, IL 62704-1462

Unlisted Fax

Mailing Location

136 Exmore Dr, Springfield, IL 62704-3138

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 101YP2500X Primary	Description Counselor Behavioral Health & Social Service Providers	License 180.008608 Illinois