Provider Demographics
NPI:1861096620
Name:BATES, KELSEY RENEE (MA LMHC, LPC, LCPC)
Entity type:Individual
Prefix:
First Name:KELSEY
Middle Name:RENEE
Last Name:BATES
Suffix:
Gender:F
Credentials:MA LMHC, LPC, LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:928 BROADWAY STE 803
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10010-8125
Mailing Address - Country:US
Mailing Address - Phone:202-902-7975
Mailing Address - Fax:
Practice Address - Street 1:928 BROADWAY STE 803
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10010-8125
Practice Address - Country:US
Practice Address - Phone:202-902-7975
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-23
Last Update Date:2025-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC11257101YP2500X
DCPRC15475101YP2500X
GA011904101YP2500X
VA0701010492101YP2500X
NY010694101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional