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Provider Information for 1801238365


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ALISA CATES LCPC


Sex: Female

NPI: 1801238365
Last Updated: 2020-04-07
Certification Date: 2020-04-07

Details

NameValue
NPI1801238365
Enumeration Date2013-07-25
NPI TypeNPI-1 Individual
Sole ProprietorYES
StatusActive
Mailing Address 108 HAWTHORNE PL APT 2
COLUMBIA, IL 62236-1029
United States

Phone: 618-340-1721 | Fax:
 
Primary Practice Address 808 S MAIN ST STE C
COLUMBIA, IL 62236-2499
United States

Phone: 618-340-1721 | Fax:
 
Secondary Practice Address(es)

988 N ILLINOIS ROUTE 3
WATERLOO, IL 62298-1000
United States

Phone: 618-939-4444 | Fax:618-939-4181
 

Health Information Exchange
Endpoint TypeEndpointEndpoint DescriptionUseContent TypeAffiliationEndpoint Location
Other Identifiers
IssuerStateNumberOther Issuer
Taxonomy
Primary TaxonomySelected TaxonomyStateLicense Number
No 101YP2500X - Counselor - ProfessionalIL180.012524
Yes 101YP2500X - Counselor - ProfessionalIL178009056