Provider Demographics
NPI:1770778128
Name:GATES, JOYCE MARIE I (MA LPCC LICDC)
Entity type:Individual
Prefix:MS
First Name:JOYCE
Middle Name:MARIE
Last Name:GATES
Suffix:I
Gender:F
Credentials:MA LPCC LICDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:164 N CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:OAK HARBOR
Mailing Address - State:OH
Mailing Address - Zip Code:43449-1342
Mailing Address - Country:US
Mailing Address - Phone:419-898-3508
Mailing Address - Fax:419-898-0322
Practice Address - Street 1:164 N CHURCH ST
Practice Address - Street 2:
Practice Address - City:OAK HARBOR
Practice Address - State:OH
Practice Address - Zip Code:43449-1342
Practice Address - Country:US
Practice Address - Phone:419-898-3508
Practice Address - Fax:419-898-0322
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-10
Last Update Date:2007-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH882419101YA0400X
OHEOOO7758101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)