Provider Demographics
NPI:1346723202
Name:BATES, ROBERT EUGENE (MA,LMHC: LH61119062)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:EUGENE
Last Name:BATES
Suffix:
Gender:M
Credentials:MA,LMHC: LH61119062
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:908 10TH AVE SW
Mailing Address - Street 2:
Mailing Address - City:QUINCY
Mailing Address - State:WA
Mailing Address - Zip Code:98848-1376
Mailing Address - Country:US
Mailing Address - Phone:425-477-9383
Mailing Address - Fax:509-765-4124
Practice Address - Street 1:16271 ROAD 9 NW
Practice Address - Street 2:
Practice Address - City:QUINCY
Practice Address - State:WA
Practice Address - Zip Code:98848-9605
Practice Address - Country:US
Practice Address - Phone:360-259-4198
Practice Address - Fax:509-423-7397
Is Sole Proprietor?:No
Enumeration Date:2018-09-07
Last Update Date:2023-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACG60892245101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor