Provider Demographics
NPI:1659976264
Name:BATES, ALLISON (LAPC, MS, BED)
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:
Last Name:BATES
Suffix:
Gender:F
Credentials:LAPC, MS, BED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1101 TREELODGE PKWY
Mailing Address - Street 2:
Mailing Address - City:SANDY SPRINGS
Mailing Address - State:GA
Mailing Address - Zip Code:30350-6043
Mailing Address - Country:US
Mailing Address - Phone:678-646-9594
Mailing Address - Fax:
Practice Address - Street 1:2750 OLD ALABAMA RD
Practice Address - Street 2:ST. 200
Practice Address - City:JOHNS CREEK
Practice Address - State:GA
Practice Address - Zip Code:30022
Practice Address - Country:US
Practice Address - Phone:678-646-9594
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-01
Last Update Date:2020-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAAPC006940101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health