Sara ER Bates, QMHP

Individual provider Active NPI Mental Health Counselor · Gresham, OR

NPI 1891210167 · NPPES record last updated Aug 8, 2017

Key facts

NPI
1891210167
Entity type
Individual (NPI type 1)
Primary specialty
Mental Health Counselor 101YM0800X
Practice address
620 NE 2ND St
Gresham, OR 97030-7514
Phone
(503) 224-1044
Fax
(503) 621-2235
NPI assigned
Aug 8, 2017
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)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X OR
Mental Health Counselor 101YM0800X OR Yes

Addresses

Primary practice location

620 NE 2ND St
Gresham, OR 97030-7514

Mailing address

1776 SW Madison St
Portland, OR 97205-1715
Phone (971) 386-2278

Other providers in Gresham, OR

All providers in Gresham, OR · Mental Health Counselor in Oregon

Sources for this page

Verify at the official NPI Registry.