Provider Demographics
NPI:1669914016
Name:BATES, ALLISON CELESTE (DSW, LCSW-S)
Entity type:Individual
Prefix:
First Name:ALLISON
Middle Name:CELESTE
Last Name:BATES
Suffix:
Gender:F
Credentials:DSW, LCSW-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 820423
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77282-0423
Mailing Address - Country:US
Mailing Address - Phone:832-598-4003
Mailing Address - Fax:832-565-1436
Practice Address - Street 1:2440 TEXAS PKWY STE 340A
Practice Address - Street 2:
Practice Address - City:MISSOURI CITY
Practice Address - State:TX
Practice Address - Zip Code:77489-4073
Practice Address - Country:US
Practice Address - Phone:832-598-4003
Practice Address - Fax:832-565-1436
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-15
Last Update Date:2023-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX591771041C0700X, 1041C0700X
171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX363983301Medicaid
TX363983301Medicaid