Harold Edward Bates Sr Sr., Ladac II , MAC
Counselor, Addiction (Substance Use Disorder) in Memphis, TN. Individual provider (NPI-1).
NPI number1720740962
StatusActive
Last updated in NPPESOct 5, 2021
Details
- NPI
- 1720740962
- Entity type
- Individual (NPI-1)
- Name
- Harold Edward Bates Sr Sr.
- Credential
- Ladac II , MAC
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Oct 5, 2021
- Certification date
- Oct 5, 2021
- Last updated
- Oct 5, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YA0400X | Counselor, Addiction (Substance Use Disorder) | LDC619 | TN | Yes |
Practice location
5565 Brook Shade LnMemphis, TN 38125-4198
Phone 901-308-9271
Mailing address
1910 Madison Ave # 3013Memphis, TN 38104-2620
Phone 901-308-9271
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