Provider Demographics
NPI:1922816644
Name:BATES, ERIK MARCUS (LCSW)
Entity type:Individual
Prefix:MR
First Name:ERIK
Middle Name:MARCUS
Last Name:BATES
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4810 MCEVER RD
Mailing Address - Street 2:
Mailing Address - City:OAKWOOD
Mailing Address - State:GA
Mailing Address - Zip Code:30566-2600
Mailing Address - Country:US
Mailing Address - Phone:678-971-4177
Mailing Address - Fax:678-971-4185
Practice Address - Street 1:4810 MCEVER RD
Practice Address - Street 2:
Practice Address - City:OAKWOOD
Practice Address - State:GA
Practice Address - Zip Code:30566-2600
Practice Address - Country:US
Practice Address - Phone:678-971-4177
Practice Address - Fax:678-971-4185
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-27
Last Update Date:2024-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACSW0083131041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical