Individual
LYNELL WESTBROOK GATES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1311 N ARLINGTON AVE STE 102, INDIANAPOLIS, IN 46219
(317) 222-5064
Mailing address
1311 N ARLINGTON AVE STE 102, INDIANAPOLIS, IN 46219-3260
(317) 222-5064
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
104100000X
Social Worker
—
—
373H00000X
Day Training/Habilitation Specialist
Primary
—
—
385H00000X
Respite Care
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300026692
—
IN
Enumeration date
04/03/2018
Last updated
10/24/2019
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