Provider Demographics
NPI:1174831309
Name:GATES, GAYLE L (LPC)
Entity Type:Individual
Prefix:
First Name:GAYLE
Middle Name:L
Last Name:GATES
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2910 FRANKS RD
Mailing Address - Street 2:
Mailing Address - City:HUNTINGDON VALLEY
Mailing Address - State:PA
Mailing Address - Zip Code:19006-4255
Mailing Address - Country:US
Mailing Address - Phone:215-947-8654
Mailing Address - Fax:215-738-7606
Practice Address - Street 1:2910 FRANKS RD
Practice Address - Street 2:
Practice Address - City:HUNTINGDON VALLEY
Practice Address - State:PA
Practice Address - Zip Code:19006-4255
Practice Address - Country:US
Practice Address - Phone:215-947-8654
Practice Address - Fax:215-738-7606
Is Sole Proprietor?:No
Enumeration Date:2010-09-22
Last Update Date:2010-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC3197101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional