Provider Demographics
NPI:1447369277
Name:BESCZEZYNSKI, PATRICIA GREEN (MS, LMHC)
Entity type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:GREEN
Last Name:BESCZEZYNSKI
Suffix:
Gender:F
Credentials:MS, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4347 SOUTH ST
Mailing Address - Street 2:
Mailing Address - City:MARIANNA
Mailing Address - State:FL
Mailing Address - Zip Code:32448-4237
Mailing Address - Country:US
Mailing Address - Phone:850-526-7488
Mailing Address - Fax:
Practice Address - Street 1:4347 SOUTH ST
Practice Address - Street 2:
Practice Address - City:MARIANNA
Practice Address - State:FL
Practice Address - Zip Code:32448-4237
Practice Address - Country:US
Practice Address - Phone:850-526-7488
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH1565101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLZ7950OtherBLUE CROSS/BLUE SHIELD
FL25026OtherCERTIFIED FORENSICS COUNS
FLMH1565OtherSTATE MENTAL HEALTH LICEN