MS. THERESA ANN KENNEDY PATTON (LCPC CRC LPC LCAC) – Addiction (Substance Use Disorder) Counselor, NPI 1114210721

MS. THERESA ANN KENNEDY PATTON (LCPC CRC LPC LCAC) is a healthcare provider. based in Washington, Illinois. specializing in MENTAL HEALTH COUNSELOR. They hold the professional credentials LCPC CRC LPC LCAC. They hold a License No. 23605 (AZ). The NPI Number for MS. THERESA ANN KENNEDY PATTON (LCPC CRC LPC LCAC) is 1114210721

Main info

Female
Sole Proprietor
20 Years Of Experience
Accepts Medicare Assignment
Name
MS. THERESA ANN KENNEDY PATTON (LCPC CRC LPC LCAC)
NPI
1114210721
Phone
(317) 799-4343
Address
617 STEPHANIE CT
Enumeration Date
16 May 2011
Last Update Date
22 February 2026

Doctor Profile

Medical School Name
OTHER
Secondary Phone
4153603348
Graduation Year
2006 (20 years ago)
PAC ID
6305102112
Group Practice PAC ID
3678948809
Professional Enrollment ID
I20240604003330
Address ID
IL606074623CH1440XSTXX457
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience90
Completeness85
Years active:15State licenses:9Digital endpointsOther names

2,308 MENTAL HEALTH COUNSELOR in IL

Provider Addresses for MS. THERESA ANN KENNEDY PATTON (LCPC CRC LPC LCAC)

  • 617 STEPHANIE CT

    WASHINGTON, IL 615719279

    Phone: (317) 799-4343

    Fax: (317) 643-8989

    Type: Mailing

  • 11925 E 65TH ST STE 3

    INDIANAPOLIS, IN 462363179

    Phone: (317) 534-6364

    Fax: (317) 643-8989

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

Loading prescription activity...

Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2024-06-04

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20240604003330IMental Health CounselorILTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 61571)

Loading plans...

Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 3678948809View full group profile
NameSpecialtyState
Mental Health CounselorWI
Mental Health CounselorIL
Mental Health CounselorIL
Mental Health CounselorMN
Mental Health CounselorAZ
Mental Health CounselorAZ
Mental Health CounselorAZ
Mental Health CounselorMA
Mental Health CounselorIN
Clinical PsychologistIL

Reviews

All reviews are moderated before publication. Reviews reflect users' opinions; we do not verify the accuracy of individual reviews.

No reviews yet. Be the first to share your experience — your opinion helps families compare providers.

Frequently asked questions

Where can patients find MS. THERESA ANN KENNEDY PATTON (LCPC CRC LPC LCAC)'s NPI?
You can confirm MS. THERESA ANN KENNEDY PATTON (LCPC CRC LPC LCAC) with NPI 1114210721; it appears in the national provider directory.
Is MS. THERESA ANN KENNEDY PATTON (LCPC CRC LPC LCAC) active in the national directory?
MS. THERESA ANN KENNEDY PATTON (LCPC CRC LPC LCAC)'s public NPI profile is in an active state.
Does MS. THERESA ANN KENNEDY PATTON (LCPC CRC LPC LCAC) list a primary specialty?
If you are matching referrals, note Addiction (Substance Use Disorder) Counselor for MS. THERESA ANN KENNEDY PATTON (LCPC CRC LPC LCAC). Clinical services aligned with this taxonomy classification.
Where is MS. THERESA ANN KENNEDY PATTON (LCPC CRC LPC LCAC)'s primary listing?
We display Washington, Illinois because that is what the record indicates for MS. THERESA ANN KENNEDY PATTON (LCPC CRC LPC LCAC).
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.