Individual
MR. DOUGLAS ALAN BATES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW, LISAC, ACHP-SW
Contact information
Practice address
3861 E GLENEAGLE PL, CHANDLER, AZ 85249-9443
(623) 695-3460
Mailing address
3861 E GLENEAGLE PL, CHANDLER, AZ 85249-9443
(623) 695-3460
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
11481
AZ
1041C0700X
Clinical Social Worker
Primary
16152
AZ
1041C0700X
Clinical Social Worker
28616
CA
Other
Enumeration date
07/06/2018
Last updated
07/06/2018
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