Provider Demographics
NPI:1538907837
Name:YONTZ, HALEIGH ADYSON (MA; LCMHC-A)
Entity type:Individual
Prefix:
First Name:HALEIGH
Middle Name:ADYSON
Last Name:YONTZ
Suffix:
Gender:F
Credentials:MA; LCMHC-A
Other - Prefix:
Other - First Name:HALEIGH
Other - Middle Name:ADYSON
Other - Last Name:YONTZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MA; LCMHC-A
Mailing Address - Street 1:1656 FLAT SHOALS RD
Mailing Address - Street 2:
Mailing Address - City:KING
Mailing Address - State:NC
Mailing Address - Zip Code:27021-7666
Mailing Address - Country:US
Mailing Address - Phone:336-972-1356
Mailing Address - Fax:
Practice Address - Street 1:942 W 4TH ST
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27101-2582
Practice Address - Country:US
Practice Address - Phone:336-355-8244
Practice Address - Fax:336-546-7630
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-19
Last Update Date:2024-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA20337101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health