George Davison Gates, LCSW
Individual provider Active NPI Psychoanalyst · Independence, MO
NPI 1265736573 · NPPES record last updated Dec 29, 2010
Key facts
- NPI
- 1265736573
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychoanalyst 102L00000X
- License
- 2006007591 (MO)
- Practice address
- 15901 E 43Rd St S
Independence, MO 64055-5044 - Phone
- (816) 373-4191
- NPI assigned
- Dec 29, 2010
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2006007591 | MO | MD | Psychoanalyst |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychoanalyst | 102L00000X | 2006007591 | MO | Yes |
Addresses
Primary practice location
15901 E 43Rd St S
Independence, MO 64055-5044
Mailing address
15901 E 43Rd St S
Independence, MO 64055-5044
Phone (816) 373-4191
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2006007591 | Other | MO | LCSW |
Other providers in Independence, MO
- Kate Garofalo
- Gary a. Boring D.C.
- Lorrie Robin Gaschler
- Jaiden Brie Gatchalian
- Clinton Ray Gates
- Albert L Gatrost
- Susan Gatrost
- Rachel Gatts
- Abbey Elizabeth Gebhardt
- Christen L Geisler
All providers in Independence, MO · Psychoanalyst in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 29, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.