Provider Demographics
NPI:1508947003
Name:BATES, JOANNE LAYTON (MS)
Entity Type:Individual
Prefix:MS
First Name:JOANNE
Middle Name:LAYTON
Last Name:BATES
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:969 KEYSTONE WAY
Mailing Address - Street 2:SUITE 100
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46032-3000
Mailing Address - Country:US
Mailing Address - Phone:317-844-7897
Mailing Address - Fax:317-844-8265
Practice Address - Street 1:969 KEYSTONE WAY
Practice Address - Street 2:SUITE 100
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46032-3000
Practice Address - Country:US
Practice Address - Phone:317-844-7897
Practice Address - Fax:317-844-8265
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN39000295A101YM0800X
IN34002226A1041C0700X
IN35000144A106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist