JOHN WALTER PATRICK PH.D.
NPI 1720015274
Psychologist - Clinical in Port Orange, FL

Q: What is John Patrick's NPI number?

The NPI number for John Patrick is 1720015274. It was assigned to this individual provider in the NPPES registry on June 27, 2006.

Q: What is John Patrick's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

Q: When was this NPI record last updated?

The NPPES record for John Patrick was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since June 27, 2006

4643 S CLYDE MORRIS BLVD, SUITE 306, PORT ORANGE, FL 32129(386) 761-3101 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About John Walter Patrick Ph.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JOHN WALTER PATRICK PH.D. (NPI 1720015274) is an individual clinical provider in Port Orange, Florida, licensed in Florida (PY3313) and active in the NPI registry since June 2006.

NPPES Registry Identity

NPI1720015274

Entity TypeIndividualMale

Primary Taxonomy103TC0700X

Provider Legal NameJOHN WALTER PATRICKCredential: PH.D.

Location Address4643 S CLYDE MORRIS BLVD, SUITE 306Port Orange, FL 32129-6000

Mailing Address5911 Riverside DrPort Orange, FL 32127-6445 · (386) 761-3101

Phone(386) 761-3101

Sole ProprietorYes

Enumeration DateJune 27, 2006

Last NPPES UpdateJuly 8, 2007

✔ NPI 1720015274 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers

Taxonomy Code103TC0700X

License✔ Licensed in FL · PY3313

Definition

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.

4643 S CLYDE MORRIS BLVD, Port Orange, FL 32129

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Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MS. CONCETTA TINA A POMROY M.A.

Counselor (Mental Health)

4643 S CLYDE MORRIS BLVD, SUITE 306
PORT ORANGE, FL 32129

Volusia County (386) 767-7252

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is John Patrick's NPI number?

The NPI number for John Patrick is 1720015274. It was assigned to this individual provider in the NPPES registry on June 27, 2006.

Where is John Patrick located?

John Patrick practices at 4643 S Clyde Morris Blvd Suite 306, Port Orange, FL 32129. The listed phone number is (386) 761-3101.

What is John Patrick's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

When was this NPI record last updated?

The NPPES record for John Patrick was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.