David B Bates, LPC

Individual provider Active NPI Professional Counselor · Fairbanks, AK

NPI 1942364112 · NPPES record last updated Dec 29, 2017

Key facts

NPI
1942364112
Entity type
Individual (NPI type 1)
Primary specialty
Professional Counselor 101YP2500X
License
408 (AK)
Practice address
122 10TH Avenue
Fairbanks, AK 99701
Phone
(907) 457-6002
Fax
(907) 457-3610
NPI assigned
Dec 21, 2006
Sex
Male
Sole proprietor
Yes

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 and National Provider Directory roles.

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
408AKMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Fairbanks Youth Advocates Professional Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 408 AK Yes

Addresses

Primary practice location

122 10TH Avenue
Fairbanks, AK 99701

Mailing address

PO Box 10337
Fairbanks, AK 99710-0337
Phone (907) 457-6002

Other providers in Fairbanks, AK

All providers in Fairbanks, AK · Professional Counselor in Alaska

Sources for this page

Verify at the official NPI Registry.