Individual provider Active NPI

Timothy Andrew Bates, LCSW

  • Clinical Social Worker
  • Auburn, ME
National Provider Identifier
1508429747
Registry record updated Oct 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LC19773 Issued in ME
Practice address
243 Mount Auburn Ave Ste 2B
Auburn, ME 04210-8522
Phone
(207) 710-0408
NPI assigned
Apr 14, 2019
Last updated
Oct 12, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 12, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X MC17869 ME
Clinical Social Worker 1041C0700X LC19773 ME Primary

Addresses

Primary practice location

243 Mount Auburn Ave Ste 2B
Auburn, ME 04210-8522

Mailing address

243 Mount Auburn Ave Ste 2B
Auburn, ME 04210-8522
Phone (207) 710-0408

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210730000297 ME Practitioner - Clinical Social Worker 0042613853 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

243 Mount Auburn Ave
Suite 2B
Auburn, ME 04210-8522
Phone (207) 710-0408

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MC17869MEMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Two Lights Counseling, LLC Clinical CurrentSince Oct 1, 2023 Accepting new patients

Locations

243 Mount Auburn Ave
Ste 2B
Auburn, ME 04210
Phone (207) 710-0408

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1555200000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697068800000",
    "number": "1508429747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "243 MOUNT AUBURN AVE STE 2B",
            "city": "AUBURN",
            "state": "ME",
            "postal_code": "042108522",
            "telephone_number": "207-710-0408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "243 MOUNT AUBURN AVE STE 2B",
            "city": "AUBURN",
            "state": "ME",
            "postal_code": "042108522",
            "telephone_number": "207-710-0408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BATES",
        "first_name": "TIMOTHY",
        "middle_name": "ANDREW",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-04-14",
        "last_updated": "2023-10-12",
        "certification_date": "2023-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ME",
            "license": "MC17869",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ME",
            "license": "LC19773",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Auburn, ME

Sources for this page

Verify at the official NPI Registry.