Provider Demographics
NPI:1265845127
Name:GLENDA BATES
Entity Type:Organization
Organization Name:GLENDA BATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED MENTAL HEALTH COUNSELOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:GLENDA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:BATES
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:561-722-7084
Mailing Address - Street 1:1604 MAPLEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:GREENACRES
Mailing Address - State:FL
Mailing Address - Zip Code:33415-1478
Mailing Address - Country:US
Mailing Address - Phone:561-722-7084
Mailing Address - Fax:561-697-9925
Practice Address - Street 1:1825 FOREST HILL BLVD
Practice Address - Street 2:SUITE 105
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33406-8902
Practice Address - Country:US
Practice Address - Phone:561-722-7084
Practice Address - Fax:561-697-9925
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-09
Last Update Date:2014-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH9355101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty