MEDICARE: WILLIAM PAUL GATES 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
1	1041C0700X	Clinical Social Worker	014714	PA

General Provider Information

NPI Number	:	1487845236
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WILLIAM PAUL GATES LCSW

Provider Business Mailing Address
First Line	:	1252 E MELROSE LOOP
Second Line	:
City	:	CASA GRANDE
State	:	AZ
Zip	:	85222-2958
Country	:	US
Telephone Number	:	520-840-0827
Fax Number	:

Provider Business Practice Location Address
First Line	:	242 MARSHALL RD APT B301
Second Line	:
City	:	PLATTE CITY
State	:	MO
Zip	:	64079-7407
Country	:	US
Telephone Number	:	816-885-7707
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/07/2007
Last Update Date	:	09/11/2025

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