Provider Demographics
NPI:1013629260
Name:BATES, KATHERINE SILVEY (MCMHC)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:SILVEY
Last Name:BATES
Suffix:
Gender:F
Credentials:MCMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:512 W ATLANTA ST
Mailing Address - Street 2:
Mailing Address - City:BROKEN ARROW
Mailing Address - State:OK
Mailing Address - Zip Code:74012-7004
Mailing Address - Country:US
Mailing Address - Phone:918-615-6620
Mailing Address - Fax:
Practice Address - Street 1:512 W ATLANTA ST
Practice Address - Street 2:
Practice Address - City:BROKEN ARROW
Practice Address - State:OK
Practice Address - Zip Code:74012-7004
Practice Address - Country:US
Practice Address - Phone:918-615-6620
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-20
Last Update Date:2022-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor