Provider Demographics
NPI:1699762005
Name:BATE, RICHARD L (LMHC)
Entity type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:L
Last Name:BATE
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:708 MONTREVILLE AVE
Mailing Address - Street 2:
Mailing Address - City:DELAND
Mailing Address - State:FL
Mailing Address - Zip Code:32724-2969
Mailing Address - Country:US
Mailing Address - Phone:386-740-8677
Mailing Address - Fax:
Practice Address - Street 1:408 S RIDGEWOOD AVE
Practice Address - Street 2:
Practice Address - City:DAYTONA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32114-4928
Practice Address - Country:US
Practice Address - Phone:386-236-3267
Practice Address - Fax:386-236-3135
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH 5078101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health