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1194935551 NPI number — CLIFFORD WADE BATES LMFT-S, LPC-S

NPI Number: 1194935551
Health Care Provider/Practitioner: CLIFFORD WADE BATES LMFT-S, LPC-S

Information about “1194935551” NPI (CLIFFORD WADE BATES LMFT-S, LPC-S) exists in 1194935551 in HTML format HTML  |  1194935551 in plain Text format TXT  |  1194935551 in PDF (Portable Document Format) PDF  |  1194935551 in an XML format XML  formats.

NPI Number : 1194935551 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1194935551",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "BATES",
    "FirstName": "CLIFFORD",
    "MiddleName": "WADE",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "LMFT-S, LPC-S",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "1121 DALLAS DR STE 6",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "DENTON",
    "MailingAddressStateName": "TX",
    "MailingAddressPostalCode": "76205-5100",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "214-277-3029",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "6404 PAIGE RD",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "THE COLONY",
    "PracticeLocationAddressStateName": "TX",
    "PracticeLocationAddressPostalCode": "75056-1861",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "972-625-6655",
    "PracticeLocationAddressFaxNumber": "972-625-6672",
    "EnumerationDate": "05/23/2007",
    "LastUpdateDate": "04/04/2024",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "M",
    "Gender": "Male",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "106H00000X",
        "TaxonomyName": "Marriage & Family Therapist",
        "LicenseNumber": "201376",
        "LicenseNumberStateCode": "TX",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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