Provider Demographics
NPI:1740933100
Name:BATES, KARA (LPC, CRC)
Entity type:Individual
Prefix:
First Name:KARA
Middle Name:
Last Name:BATES
Suffix:
Gender:F
Credentials:LPC, CRC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12451 STABLE DR
Mailing Address - Street 2:
Mailing Address - City:NEW LONDON
Mailing Address - State:MO
Mailing Address - Zip Code:63459-2404
Mailing Address - Country:US
Mailing Address - Phone:573-207-9338
Mailing Address - Fax:
Practice Address - Street 1:12451 STABLE DR
Practice Address - Street 2:
Practice Address - City:NEW LONDON
Practice Address - State:MO
Practice Address - Zip Code:63459-2404
Practice Address - Country:US
Practice Address - Phone:573-207-9338
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-26
Last Update Date:2022-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2020024465101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor