Provider Demographics
NPI:1144879156
Name:BATES, INESHIA RESHAWN (LCSW)
Entity type:Individual
Prefix:MISS
First Name:INESHIA
Middle Name:RESHAWN
Last Name:BATES
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:INESHIA
Other - Middle Name:RESHAWN
Other - Last Name:GOODS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7717 HICKMAN ST
Mailing Address - Street 2:
Mailing Address - City:TEMPLE
Mailing Address - State:TX
Mailing Address - Zip Code:76502-6112
Mailing Address - Country:US
Mailing Address - Phone:910-709-8531
Mailing Address - Fax:
Practice Address - Street 1:7717 HICKMAN ST
Practice Address - Street 2:
Practice Address - City:TEMPLE
Practice Address - State:TX
Practice Address - Zip Code:76502-6112
Practice Address - Country:US
Practice Address - Phone:910-709-8531
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-11
Last Update Date:2022-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0144041041C0700X
NCP0134441041C0700X
TX1083491041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical