Provider Demographics
NPI:1003303884
Name:WARE, GATT READ SR (TLCADC, BIP)
Entity Type:Individual
Prefix:MR
First Name:GATT
Middle Name:READ
Last Name:WARE
Suffix:SR
Gender:M
Credentials:TLCADC, BIP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1043 PEDIGO WAY STE 30
Mailing Address - Street 2:
Mailing Address - City:BOWLING GREEN
Mailing Address - State:KY
Mailing Address - Zip Code:42103-6124
Mailing Address - Country:US
Mailing Address - Phone:270-495-1224
Mailing Address - Fax:270-599-0023
Practice Address - Street 1:1043 PEDIGO WAY STE 30
Practice Address - Street 2:
Practice Address - City:BOWLING GREEN
Practice Address - State:KY
Practice Address - Zip Code:42103-6124
Practice Address - Country:US
Practice Address - Phone:270-495-1224
Practice Address - Fax:270-599-0023
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-17
Last Update Date:2018-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY164501101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty