Provider Demographics
NPI:1407286768
Name:GATES, ALLISON PATRICE (LMHC)
Entity Type:Individual
Prefix:MS
First Name:ALLISON
Middle Name:PATRICE
Last Name:GATES
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:53 PARKE AVE APT 1
Mailing Address - Street 2:
Mailing Address - City:NORTH QUINCY
Mailing Address - State:MA
Mailing Address - Zip Code:02171-1166
Mailing Address - Country:US
Mailing Address - Phone:508-596-6054
Mailing Address - Fax:
Practice Address - Street 1:53 PARKE AVE APT 1
Practice Address - Street 2:
Practice Address - City:NORTH QUINCY
Practice Address - State:MA
Practice Address - Zip Code:02171-1166
Practice Address - Country:US
Practice Address - Phone:508-596-6054
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-22
Last Update Date:2023-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X, 104100000X
MA11530101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No104100000XBehavioral Health & Social Service ProvidersSocial Worker