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JOHN WALTER PATRICK PH.D. NPI 1720015274


NPI Information

NPI: 1720015274
Provider Name: JOHN WALTER PATRICK, PH.D.
Classification: Psychologist - 103TC0700X
Entity Type: Individual

Specialization: Clinical

Address:
4643 S CLYDE MORRIS BLVD
SUITE 306
PORT ORANGE, FL
ZIP 32129
Phone: (386) 761-3101
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John Walter Patrick, PH.D. is a clinical psychologist in Port Orange, FL. The provider is a psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems. John Walter Patrick, PH.D. NPI is 1720015274. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

4643 S CLYDE MORRIS BLVD
SUITE 306
PORT ORANGE, FL
ZIP 32129-000
Phone: (386) 761-3101

The enumeration date for this NPI number is 6/27/2006 and was last updated on 7/8/2007.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1103TC0700XPsychologistClinicalPY3313FLORIDAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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