Sandra L Bates, LMSW
Social Worker, Clinical in Portage, MI. Individual provider (NPI-1).
NPI number1063966331
StatusActive
Last updated in NPPESOct 11, 2022
Details
- NPI
- 1063966331
- Entity type
- Individual (NPI-1)
- Name
- Sandra L Bates
- Credential
- LMSW
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Aug 4, 2016
- Certification date
- Oct 11, 2022
- Last updated
- Oct 11, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1041C0700X | Social Worker, Clinical | 6801115031 | MI | Yes |
| 1041C0700X | Social Worker, Clinical | 6801100121 | MI |
Practice location
10332 Shaver RdPortage, MI 49024-6744
Phone 269-993-0112
Mailing address
10332 Shaver RdPortage, MI 49024-6744
Phone 269-993-0112
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