Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

MS. Theresa Ann Kennedy Patton, LCPCCRCLPCLCAC

Individual provider Addiction (Substance Use Disorder) Counselor · NPI 1114210721

MS. Theresa Ann Kennedy Patton, LCPCCRCLPCLCAC is a Mental Health Counselor in Washington, Illinois. Qualified in 2006, 20 years ago. Practices with Brightside Medical PA, a 95-clinician group and accepts Medicare assignment. Licensed in Arizona, Illinois, Indiana and Missouri and 3 more.

Years since qualifying
20
Licensed in
AZ, IL, IN, MO, NC, TX
In the registry since
2011
Specialties on file
10

Practice location Address checks out

617 Stephanie Ct
Washington, IL 61571-9279
Phone: (317) 799-4343
Fax: (317) 643-8989
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Mental Health Counselor (primary) Taxonomy 101YM0800X · Licence 180015238 (IL)
Addiction (Substance Use Disorder) Counselor Taxonomy 101YA0400X · Licence 16405 (TX)
Addiction (Substance Use Disorder) Counselor Taxonomy 101YA0400X · Licence 15216 (AZ)
Mental Health Counselor Taxonomy 101YM0800X · Licence 2025015218 (MO)
Mental Health Counselor Taxonomy 101YM0800X · Licence 11965125 (WI)
Addiction (Substance Use Disorder) Counselor Taxonomy 101YA0400X · Licence 87001357A (IN)
Addiction (Substance Use Disorder) Counselor Taxonomy 101YA0400X · Licence 1804 (NC)
Rehabilitation Counselor Taxonomy 225C00000X · Licence 204377 (IL)
Mental Health Counselor Taxonomy 101YM0800X · Licence 23605 (AZ)
Professional Counselor Taxonomy 101YP2500X · Licence 23605 (AZ)

Record details

NPI number1114210721
Entity typeIndividual (Type 1)
GenderFemale
Credentials LCPCCRCLPCLCAC
Sole proprietorYes
NPI enumeratedMay 16, 2011
Last updated in NPPESJune 25, 2026
Certification dateJune 25, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyMENTAL HEALTH COUNSELOR
Medical schoolOTHER
Graduated 2006 (20 years in practice)
Group practice Brightside Medical Pa — 95 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount