MEDICARE: MRS. ANDREA C. BATES LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	LC23049	ME
2	1041C0700X	Clinical Social Worker	C006280	NC

General Provider Information

NPI Number	:	1962744953
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ANDREA C. BATES LCSW

Provider Business Mailing Address
First Line	:	12425 KENDALL RIDGE CT
Second Line	:
City	:	DURHAM
State	:	NC
Zip	:	27703-8543
Country	:	US
Telephone Number	:	919-457-8311
Fax Number	:

Provider Business Practice Location Address
First Line	:	12425 KENDALL RIDGE CT
Second Line	:
City	:	DURHAM
State	:	NC
Zip	:	27703-8543
Country	:	US
Telephone Number	:	919-457-8311
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/18/2013
Last Update Date	:	03/06/2026

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