Provider Demographics
NPI:1356061741
Name:BATES, BRITTANY NICOLE (LPC, LSSP)
Entity type:Individual
Prefix:
First Name:BRITTANY
Middle Name:NICOLE
Last Name:BATES
Suffix:
Gender:F
Credentials:LPC, LSSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3838 N BRAESWOOD BLVD APT 219
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77025-3015
Mailing Address - Country:US
Mailing Address - Phone:601-807-6439
Mailing Address - Fax:
Practice Address - Street 1:800 BONAVENTURE WAY STE 116
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479-8005
Practice Address - Country:US
Practice Address - Phone:832-757-5856
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-29
Last Update Date:2022-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX85191101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional