Provider Demographics
NPI:1396928529
Name:BATES, DANN TODD (CSW)
Entity type:Individual
Prefix:MR
First Name:DANN
Middle Name:TODD
Last Name:BATES
Suffix:
Gender:M
Credentials:CSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3181 KEITHSHIRE WAY
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40503-3479
Mailing Address - Country:US
Mailing Address - Phone:859-806-8062
Mailing Address - Fax:
Practice Address - Street 1:3181 KEITHSHIRE WAY
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40503-3479
Practice Address - Country:US
Practice Address - Phone:859-806-8062
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-11
Last Update Date:2007-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYKY-38231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical