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General NPI Number Information
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NPI Number | 1174704142
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Entity Type | Individual
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Provider Name | AH'NONDA BATES MS, LCAC
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Gender | Female
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Dates
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Enumeration Date | 11/19/2007
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Last Update Date | 07/24/2018
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Provider Practice Location Address
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Address Line | 8320 MADISON AVE
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City | INDIANAPOLIS
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State | IN
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Zip | 46227
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Country | US
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Telephone | 317-882-5122
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Fax | 317-888-8642
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Provider Business Mailing Address
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Address Line | 5101 E US HIGHWAY 36 STE 100
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City | AVON
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State | IN
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Zip | 46123-6646
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Country | US
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Telephone | 888-714-1927
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Fax | 317-745-9565
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 87001001A
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License Number State | IN
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