Iranetta Bates
Individual provider Active NPI Counselor · Forest, MS
NPI 1356065197 · NPPES record last updated Sep 26, 2022
Key facts
- NPI
- 1356065197
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Counselor 101Y00000X
- Practice address
- 2071 Highway 35 S Ste C
Forest, MS 39074-7838 - Phone
- (601) 469-2422
- NPI assigned
- Sep 26, 2022
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | Yes |
Addresses
Primary practice location
2071 Highway 35 S Ste C
Forest, MS 39074-7838
Mailing address
2071 Highway 35 S Ste C
Forest, MS 39074-7838
Other providers in Forest, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 26, 2022. 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.