National Provider Identifier

Thaddeus Bates

Thaddeus Bates is listed in the NPPES registry with a primary specialty of Clinical Social Worker in Ithaca, NY and a listed phone number of (607) 255-2673.

NPI 1164018784Ithaca, NYClinical Social Worker

Profile Overview

NPI
1164018784
Provider Type
Individual
Primary Specialty
Clinical Social Worker
Enumeration Date
December 17, 2020
Last Updated
October 17, 2022

Practice Location

  • 312 College Ave Ste A
  • Ithaca, NY 14850-4700

Phone: (607) 255-2673

Specialties

  • Clinical Social Worker (1041C0700X)
  • Social Worker (104100000X)
Full Record
NPI
1164018784
Entity Type
Individual
Last Name
Bates
First Name
Thaddeus
Name Prefix
Mr.
Mailing Street Address
312 College Ave Ste A
Mailing City
Ithaca
Mailing State
NY
Mailing ZIP Code
14850-4700
Mailing Country
US
Mailing Phone
(607) 255-2673
Practice Street Address
312 College Ave Ste A
Practice City
Ithaca
Practice State
NY
Practice ZIP Code
14850-4700
Practice Country
US
Practice Phone
(607) 255-2673
Enumeration Date
December 17, 2020
Last Updated
October 17, 2022
Sex
Male
Sole Proprietor
Yes
Taxonomy Group 1
193400000X Single Specialty Group
Certification Date
October 17, 2022
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Clinical Social Worker (1041C0700X), Social Worker (104100000X)