Provider Demographics
NPI:1235704594
Name:BATES, LYNSEY (BCBA)
Entity type:Individual
Prefix:
First Name:LYNSEY
Middle Name:
Last Name:BATES
Suffix:
Gender:
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:993 MASON HEADLEY RD STE 50
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40504-2246
Mailing Address - Country:US
Mailing Address - Phone:855-444-5664
Mailing Address - Fax:317-520-8200
Practice Address - Street 1:993 MASON HEADLEY RD STE 50
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40504-2246
Practice Address - Country:US
Practice Address - Phone:855-444-5664
Practice Address - Fax:317-520-8200
Is Sole Proprietor?:No
Enumeration Date:2021-05-20
Last Update Date:2025-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1-25-79598103K00000X
KYRBT-21-168429106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician