Provider Demographics
NPI:1407805104
Name:CATES, JAMES ARTHUR (PHD, , HSPP, ABPP)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:ARTHUR
Last Name:CATES
Suffix:
Gender:M
Credentials:PHD, , HSPP, ABPP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 5391
Mailing Address - Street 2:
Mailing Address - City:FORT WAYNE
Mailing Address - State:IN
Mailing Address - Zip Code:46895-5391
Mailing Address - Country:US
Mailing Address - Phone:260-493-3980
Mailing Address - Fax:260-424-3530
Practice Address - Street 1:2200 LAKE AVE
Practice Address - Street 2:SUITE 260
Practice Address - City:FORT WAYNE
Practice Address - State:IN
Practice Address - Zip Code:46805-5397
Practice Address - Country:US
Practice Address - Phone:260-493-3980
Practice Address - Fax:260-424-3530
Is Sole Proprietor?:No
Enumeration Date:2006-05-09
Last Update Date:2010-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN20040888A103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200002660Medicaid
IN200002660Medicaid
R70890Medicare UPIN