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Individual

HEATHER M BATES

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPC, LISAC

Contact information

Practice address
6915 E MAIN ST, MESA, AZ 85207-8229
(602) 599-5584
(602) 599-5884
Mailing address
202 E EARLL DR, SUITE 200, PHOENIX, AZ 85012-2647
(602) 599-5404
(602) 599-5704

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
LISAC-10482
AZ
101YP2500X
Professional Counselor
Primary
LPC-13075
AZ

Other

Enumeration date
11/12/2014
Last updated
11/12/2014
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