Healthcare Provider Details

I. General information

NPI: 1972944403
Provider Name (Legal Business Name): LAKITIA BATES LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/12/2013
Last Update Date: 05/18/2026
Certification Date: 05/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2912 S DOUGLAS BLVD STE A
MIDWEST CITY OK
73130-7179
US

IV. Provider business mailing address

2912 S DOUGLAS BLVD STE A
MIDWEST CITY OK
73130-7179
US

V. Phone/Fax

Practice location:
  • Phone: 405-633-7767
  • Fax:
Mailing address:
  • Phone: 405-633-7767
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number22321
License Number StateOK
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: