Healthcare Provider Details

I. General information

NPI: 1831383017
Provider Name (Legal Business Name): ELIZABETH A GATES PMHNP-BC, LPC-MHSP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/30/2007
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5819 WINDING LN STE 133
HIXSON TN
37343-4067
US

IV. Provider business mailing address

5819 WINDING LN STE 133
HIXSON TN
37343-4067
US

V. Phone/Fax

Practice location:
  • Phone: 423-290-7237
  • Fax: 423-285-6160
Mailing address:
  • Phone: 423-290-7237
  • Fax: 423-285-6160

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number3134
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number36141
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: