Provider Demographics
NPI:1851988794
Name:BATES, ANJOLINA (LPC, LMFT)
Entity Type:Individual
Prefix:
First Name:ANJOLINA
Middle Name:
Last Name:BATES
Suffix:
Gender:F
Credentials:LPC, LMFT
Other - Prefix:
Other - First Name:ANGIE
Other - Middle Name:
Other - Last Name:BATES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LPC, LMFT
Mailing Address - Street 1:PO BOX 241682
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72223-0012
Mailing Address - Country:US
Mailing Address - Phone:501-242-0405
Mailing Address - Fax:
Practice Address - Street 1:17724 I-30
Practice Address - Street 2:SUITE A4, OFFICE 1
Practice Address - City:BENTON
Practice Address - State:AR
Practice Address - Zip Code:72019
Practice Address - Country:US
Practice Address - Phone:501-242-0405
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-27
Last Update Date:2023-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARP2210007101YP2500X
ARM2210001106H00000X
ARF2011010106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional