Provider Demographics
NPI:1013608520
Name:BATES, GABRIELLE R (LCSW)
Entity type:Individual
Prefix:
First Name:GABRIELLE
Middle Name:R
Last Name:BATES
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:GABRIELLE
Other - Middle Name:
Other - Last Name:ENGELMANN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:6334 CHANTILLY PL
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80922-1102
Mailing Address - Country:US
Mailing Address - Phone:719-502-6005
Mailing Address - Fax:
Practice Address - Street 1:731 N WEBER ST
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80903-1049
Practice Address - Country:US
Practice Address - Phone:719-301-0172
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-16
Last Update Date:2025-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COACD.0002635101YA0400X
COCSW.099293061041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)