Provider Demographics
NPI:1073184123
Name:BATES, CAROLYN R (PHD)
Entity Type:Individual
Prefix:
First Name:CAROLYN
Middle Name:R
Last Name:BATES
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2000 OLATHE
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:KS
Mailing Address - Zip Code:66160-8505
Mailing Address - Country:US
Mailing Address - Phone:913-588-6300
Mailing Address - Fax:913-588-2253
Practice Address - Street 1:2000 OLATHE
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66160-8500
Practice Address - Country:US
Practice Address - Phone:913-588-3798
Practice Address - Fax:913-588-2253
Is Sole Proprietor?:No
Enumeration Date:2021-07-08
Last Update Date:2021-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist