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General NPI Number Information
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NPI Number | 1346906674
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Entity Type | Individual
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Provider Name | REBECCA CHRISTINE GATES LPC, LMSW
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Gender | Female
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Dates
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Enumeration Date | 11/10/2021
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Last Update Date | 11/10/2021
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Provider Practice Location Address
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Address Line | 9800 HILLWOOD PKWY STE 140
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City | FORT WORTH
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State | TX
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Zip | 76177-1532
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Country | US
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Telephone | 682-667-4164
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Fax |
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Provider Business Mailing Address
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Address Line | 1104 LAKIN RD
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City | FORT WORTH
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State | TX
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Zip | 76177-1827
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Country | US
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Telephone | 682-667-4164
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Fax |
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 37168
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 71627
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License Number State | TX
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