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NPI Code Detail

MEDICARE: JESSICA SUE BATES LCSW

MEDICARE: JESSICA SUE BATES LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social WorkerC014909NC

General Provider Information

NPI Number : 1437671872
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESSICA SUE BATES LCSW
Provider Business Mailing Address
First Line : 1594 NC HIGHWAY 101
Second Line :
City : BEAUFORT
State : NC
Zip : 28516-7731
Country : US
Telephone Number : 910-546-9417
Fax Number :
Provider Business Practice Location Address
First Line : 200 TARPON TRL
Second Line :
City : JACKSONVILLE
State : NC
Zip : 28546-5287
Country : US
Telephone Number : 910-938-1114
Fax Number : 910-938-1118
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/07/2017
Last Update Date : 12/12/2025

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Directions to “ JESSICA SUE BATES LCSW” Practice Location

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