Provider Demographics
NPI:1447892567
Name:KAREN PATTY, PLLC
Entity type:Organization
Organization Name:KAREN PATTY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:PATTY
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:406-209-8951
Mailing Address - Street 1:1627 W. MAIN ST
Mailing Address - Street 2:PMB 351
Mailing Address - City:BOZEMAN
Mailing Address - State:MT
Mailing Address - Zip Code:59715-4011
Mailing Address - Country:US
Mailing Address - Phone:406-209-8951
Mailing Address - Fax:
Practice Address - Street 1:1946 STADIUM DR STE 2
Practice Address - Street 2:
Practice Address - City:BOZEMAN
Practice Address - State:MT
Practice Address - Zip Code:59715-0696
Practice Address - Country:US
Practice Address - Phone:406-209-8951
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-09
Last Update Date:2019-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty