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General NPI Number Information
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NPI Number | 1225243470
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Entity Type | Organization
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Legal Business Name | PAMELA GATES MA LPC, LCDC, INC
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Dates
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Enumeration Date | 05/11/2007
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Last Update Date | 11/13/2012
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Provider Practice Location Address
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Address Line | 2499 S CAPITAL OF TEXAS HWY BLDG. B, SUITE 201
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City | AUSTIN
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State | TX
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Zip | 78746-7762
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Country | US
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Telephone | 512-328-2563
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Fax |
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Provider Business Mailing Address
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Address Line | 616 PETERSON LN
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City | LAKEWAY
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State | TX
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Zip | 78734-4108
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Country | US
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Telephone | 512-328-2563
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. PAMELA H GATES I
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Credential | LPC-S,LCDC, ADCIII
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Telephone | 512-328-2563
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 6991
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License Number State | TX
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