Samuel Bates, LMFT

Individual provider Active NPI Marriage & Family Therapist · Woodbridge, VA

NPI 1801677281 · NPPES record last updated Oct 11, 2023

Key facts

NPI
1801677281
Entity type
Individual (NPI type 1)
Primary specialty
Marriage & Family Therapist 106H00000X
License
0717002027 (VA)
Practice address
13000 Harbor Center Dr Ste 302
Woodbridge, VA 22192-2847
Phone
(703) 492-2994
NPI assigned
Oct 11, 2023
Sex
Male
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

State licenses

LicenseStateTypeSpecialty
0717002027VAMDMarriage & Family Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 0717002027 VA Yes

Addresses

Primary practice location

13000 Harbor Center Dr Ste 302
Woodbridge, VA 22192-2847

Mailing address

13000 Harbor Center Dr Ste 302
Woodbridge, VA 22192-2847
Phone (703) 492-2994

Other providers in Woodbridge, VA

All providers in Woodbridge, VA · Marriage & Family Therapist in Virginia

Sources for this page

Verify at the official NPI Registry.