Provider Demographics
NPI:1972073476
Name:SLAPPEY BATES, DARLENE RENEE (LPC)
Entity Type:Individual
Prefix:
First Name:DARLENE
Middle Name:RENEE
Last Name:SLAPPEY 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 1:100 ELM ST
Mailing Address - Street 2:
Mailing Address - City:GROVETOWN
Mailing Address - State:GA
Mailing Address - Zip Code:30813-2373
Mailing Address - Country:US
Mailing Address - Phone:706-589-4001
Mailing Address - Fax:
Practice Address - Street 1:723 INDUSTRIAL PARK DR UNIT A
Practice Address - Street 2:
Practice Address - City:EVANS
Practice Address - State:GA
Practice Address - Zip Code:30809-4352
Practice Address - Country:US
Practice Address - Phone:706-842-8146
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-28
Last Update Date:2021-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC010336101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000606383VMedicaid