Healthcare Provider Details

I. General information

NPI: 1972424604
Provider Name (Legal Business Name): KATES COACHING & LIFE COACHING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/21/2026
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

220 E VIRGINIA ST
EVANSVILLE IN
47711-5530
US

IV. Provider business mailing address

220 E VIRGINIA ST
EVANSVILLE IN
47711-5530
US

V. Phone/Fax

Practice location:
  • Phone: 812-454-6764
  • Fax:
Mailing address:
  • Phone: 812-454-6764
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: MARIDETH KATES
Title or Position: OWNER
Credential: LCSW
Phone: 812-454-6764