Provider Demographics
NPI:1841683208
Name:BATES, CHELSEA SHANNON (LMFT)
Entity type:Individual
Prefix:MISS
First Name:CHELSEA
Middle Name:SHANNON
Last Name:BATES
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 E 11TH ST
Mailing Address - Street 2:SUITE LL1
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98660-3200
Mailing Address - Country:US
Mailing Address - Phone:971-249-2006
Mailing Address - Fax:
Practice Address - Street 1:205 E 11TH ST
Practice Address - Street 2:SUITE LL1
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98660-3200
Practice Address - Country:US
Practice Address - Phone:971-249-2006
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-10
Last Update Date:2024-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORT1038106H00000X
WALF60538332106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist