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General NPI Number Information
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NPI Number | 1801238365
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Entity Type | Individual
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Provider Name | ALISA CATES LCPC
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Gender | Female
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Dates
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Enumeration Date | 07/25/2013
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Last Update Date | 04/07/2020
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Provider Practice Location Address
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Address Line | 808 S MAIN ST STE C
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City | COLUMBIA
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State | IL
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Zip | 62236-2499
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Country | US
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Telephone | 618-340-1721
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Fax |
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Provider Business Mailing Address
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Address Line | 108 HAWTHORNE PL APT 2
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City | COLUMBIA
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State | IL
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Zip | 62236-1029
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Country | US
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Telephone | 618-340-1721
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 180.012524
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License Number State | IL
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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 | 178009056
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License Number State | IL
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