Mallisa P Bates
Individual provider Active NPI Mental Health Counselor · Brookings, OR
NPI 1770047425 · NPPES record last updated Jan 28, 2019
Key facts
- NPI
- 1770047425
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- Practice address
- 210 Cove Rd
Brookings, OR 97415-2520 - Phone
- (541) 469-0222
- Fax
- (541) 469-0228
- NPI assigned
- Jan 28, 2019
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Columbiacare Services | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | Yes |
Addresses
Primary practice location
210 Cove Rd
Brookings, OR 97415-2520
Mailing address
3587 Heathrow Way
Medford, OR 97504-4004
Phone (541) 858-8170
Other providers in Brookings, OR
- Azalea Family Health Care LLC
- Kalani Baker
- Bandon Community Health Center
- Clinton Frederick Barsuglia
- Mary Christine Barvoets
- Holly Ann Battleson
- Suzanne Bedke
- Ashley N Benson
- Hazel Berry
- Better Health Family Medical, LLC
All providers in Brookings, OR · Mental Health Counselor in Oregon
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 28, 2019. 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.