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Deactivated NPI 1295953198 Deactivated / Inactive NPI Male Practitioner

Dr. Brooks Kendall Bates , PhD

Psychologist - Adult Development & Aging • Crestview, FL

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Brooks Bates has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date April 23, 2007
NPI Deactivation Date November 25, 2020
Total Practice Duration ~13 Years of Practice (2007 – 2020)

Professional Overview & Biography Verified Profile Summary

Dr. Brooks Bates, PhD was a registered Psychologist - Adult Development & Aging practicing in Crestview, FL. Throughout an active medical career spanning 13 years, Dr. Bates provided care at the practice location at 259 E OAKDALE AVE until profile deactivation on 2020-11-25.

Practice Location & Contact Primary Location

Practice Address

259 E Oakdale Ave

Crestview, FL 325393547

Telephone 8503985255
Fax 8506898799
Associated Practice Facility / Clinic
🏢 Counseling Inc Facility NPI 1316053135

Specialty Benchmarks & Practice Insights

Comparative analytics for Psychologist - Adult Development & Aging in Crestview, FL

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 21.0 Yrs
Regional Practice Density
1 Specialists

Practicing in Crestview, FL (19 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Psychologist - Adult Development & Aging Primary Specialty

NUCC Taxonomy Code: 103TA0700X

State License FL PY4577

A psychologist who specializes in geropsychology, which applies the knowledge and methods of psychology to understanding and helping older persons and their families to maintain well-being, overcome problems and achieve maximum potential during later life. Professional geropsychology appreciates the wide diversity among older adults, the complex ethical issues that can arise in geriatric practice and the importance of interdisciplinary models of care.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

5 Associated Practitioners
Kristin Page , LMHC

Psychoanalyst

NPI 1083904684

Licensed Mental Health Counselor

Jessica Urena

Counselor - Mental Health

NPI 1336498443
Ericka Sam , LCSW

Social Worker - Clinical

NPI 1366719130

Licensed Clinical Social Worker

Sharon Wise , LMHC

Counselor - Mental Health

NPI 1649580275

Licensed Mental Health Counselor

April Butryn , LMHC

Counselor - Mental Health

NPI 1710250311

Licensed Mental Health Counselor

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated November 25, 2020

Record deactivated on November 25, 2020

NPI Profile Active January 14, 2011

NPI status registered as active in NPPES database

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Updated Practice Location January 14, 2011

Registered at 259 E OAKDALE AVE, CRESTVIEW, FL 325393547 (Tel: 8503985255)

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Updated Business Mailing Address January 14, 2011

Registered at PO BOX 761, WINTER PARK, FL 327900761 (Tel: 4075955535)

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Provider Name / Credentials Updated January 14, 2011

Recorded as BROOKS BATES, PH.D.

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Medical Taxonomy / Specialty Registered (Primary Specialty) January 14, 2011

Psychologist (License #PY4577 in FL)

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Initial NPI Registration & Enumeration April 23, 2007

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1295953198
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: April 23, 2007
Last Update: January 14, 2011
Deactivation Date: November 25, 2020

Mailing Address

Po Box 761

Winter Park, FL 327900761

Phone: 4075955535

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

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