Provider Demographics
NPI:1265778336
Name:BATES, WILLIAM F IV (LPC)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:F
Last Name:BATES
Suffix:IV
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11260 UPTOWN AVE
Mailing Address - Street 2:
Mailing Address - City:BROOMFIELD
Mailing Address - State:CO
Mailing Address - Zip Code:80021-4247
Mailing Address - Country:US
Mailing Address - Phone:303-434-0754
Mailing Address - Fax:
Practice Address - Street 1:11260 UPTOWN AVE
Practice Address - Street 2:
Practice Address - City:BROOMFIELD
Practice Address - State:CO
Practice Address - Zip Code:80021-4247
Practice Address - Country:US
Practice Address - Phone:303-434-0754
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-12-18
Last Update Date:2022-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPCC.0013391101YM0800X
COLPC.0013587101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health