Provider Demographics
NPI:1700037132
Name:BATES, ROBIN M (LPC)
Entity Type:Individual
Prefix:MRS
First Name:ROBIN
Middle Name:M
Last Name:BATES
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24900 TREETOP LN
Mailing Address - Street 2:
Mailing Address - City:ST ROBERT
Mailing Address - State:MO
Mailing Address - Zip Code:65584
Mailing Address - Country:US
Mailing Address - Phone:573-528-0485
Mailing Address - Fax:
Practice Address - Street 1:24530 SOUTHSIDE RD
Practice Address - Street 2:STE. D
Practice Address - City:WAYNESVILLE
Practice Address - State:MO
Practice Address - Zip Code:65583-3317
Practice Address - Country:US
Practice Address - Phone:573-528-0485
Practice Address - Fax:573-774-2535
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-03
Last Update Date:2014-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2008027568101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional