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General NPI Number Information
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NPI Number | 1861096620
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Entity Type | Individual
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Provider Name | KELSEY RENEE BATES M.A. LMHC, LPC, LCPC
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Gender | Female
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Dates
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Enumeration Date | 11/23/2020
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Last Update Date | 04/28/2025
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Provider Practice Location Address
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Address Line | 928 BROADWAY STE 803
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City | NEW YORK
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State | NY
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Zip | 10010-8125
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Country | US
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Telephone | 202-902-7975
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Fax |
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Provider Business Mailing Address
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Address Line | 928 BROADWAY STE 803
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City | NEW YORK
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State | NY
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Zip | 10010-8125
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Country | US
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Telephone | 202-902-7975
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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 | LC11257
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License Number State | MD
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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 | PRC15475
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License Number State | DC
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Taxonomy #3
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 011904
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License Number State | GA
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Taxonomy #4
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 0701010492
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License Number State | VA
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Taxonomy #5
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 010694
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License Number State | NY
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