MEDICARE: LEONA 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
1	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1710665096
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LEONA BATES LCSW

Provider Business Mailing Address
First Line	:	5250 CHEROKEE AVE STE 211
Second Line	:
City	:	ALEXANDRIA
State	:	VA
Zip	:	22312-2052
Country	:	US
Telephone Number	:	703-763-4274
Fax Number	:

Provider Business Practice Location Address
First Line	:	5250 CHEROKEE AVE STE 211
Second Line	:
City	:	ALEXANDRIA
State	:	VA
Zip	:	22312-2052
Country	:	US
Telephone Number	:	703-764-4274
Fax Number	:

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

Provider Enumeration Date	:	07/07/2023
Last Update Date	:	05/11/2026

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