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Russell Walton Bates JR., LLC
Counselor in Grand Rapids, Michigan
NPI 1043592991

Russell Walton Bates JR. is a Counselor based in Berrien Springs, MI. Russell Walton Bates JR. practices in Grand Rapids, MI and has the professional credentials of LLC. The NPI Number for Russell Walton Bates JR. is 1043592991 and holds a License No. 6401011607 (Michigan).

The current practice location address for Russell Walton Bates JR. is 40 Jefferson Ave Se, Grand Rapids, MI and can be reached out via phone at 616-456-1443 and via fax at 616-732-6392.

Location: 40 Jefferson Ave Se, Grand Rapids, MI, 49103-9543
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1043592991
Provider Name
Russell Walton Bates JR.
Credential
LLC
Provider Entity Type
Individual
Gender
Male
Address
40 Jefferson Ave Se, Grand Rapids, MI, 49103-9543
Phone Number
616-456-1443
Fax Number
616-732-6392
Provider Enumeration Date
09/16/2011
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
40 Jefferson Ave Se
City
Grand Rapids
State
Michigan
Zip
49503-4304
Phone Number
616-456-1443
Fax Number
616-732-6392
person
Provider Business Mailing Address Details
Address
40 Jefferson Ave Se
City
Grand Rapids
State
Michigan
Zip
49503-4304
Phone Number
616-456-1443
Fax Number
616-732-6392
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
-
Taxonomy
101Y00000X
License No.
6401011607 (Michigan)
Definition
A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification.
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