Provider Demographics
NPI:1720013014
Name:CATES, AMY T (LCSW)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:T
Last Name:CATES
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 N UNIVERSITY AVE STE 133
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72207-6344
Mailing Address - Country:US
Mailing Address - Phone:012-935-0127
Mailing Address - Fax:501-226-2056
Practice Address - Street 1:1100 N UNIVERSITY AVE STE 133
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72207-6344
Practice Address - Country:US
Practice Address - Phone:501-293-0127
Practice Address - Fax:501-226-2056
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-12
Last Update Date:2021-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR1830-C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR5X651OtherBLUECROSS BLUESHIELD
AR5X651Medicare ID - Type Unspecified