Provider Demographics
NPI:1104090992
Name:BATES COUNSELING & CONSULTATION, LLC
Entity type:Organization
Organization Name:BATES COUNSELING & CONSULTATION, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROFESSIONAL COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINA
Authorized Official - Middle Name:
Authorized Official - Last Name:BATES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-829-9435
Mailing Address - Street 1:2101 E BROADWAY RD STE 5
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85282-1735
Mailing Address - Country:US
Mailing Address - Phone:480-829-9435
Mailing Address - Fax:
Practice Address - Street 1:2101 E BROADWAY RD
Practice Address - Street 2:SUITE 5
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85282-1879
Practice Address - Country:US
Practice Address - Phone:480-829-9435
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-14
Last Update Date:2008-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC12145101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty