Provider Demographics
NPI:1336028547
Name:YEWELL, JAMES BRIAN (LAAC)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:BRIAN
Last Name:YEWELL
Suffix:
Gender:M
Credentials:LAAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8204 N WHITE STALLION PL
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85743-8853
Mailing Address - Country:US
Mailing Address - Phone:520-333-8335
Mailing Address - Fax:
Practice Address - Street 1:8204 N WHITE STALLION PL
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85743-8853
Practice Address - Country:US
Practice Address - Phone:520-333-8335
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-01
Last Update Date:2025-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLAAC-15617101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)