Provider Demographics
NPI:1750884201
Name:YEAGLEY, ROSE (MS, LPC, AADC)
Entity type:Individual
Prefix:
First Name:ROSE
Middle Name:
Last Name:YEAGLEY
Suffix:
Gender:F
Credentials:MS, LPC, AADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:376 W PALMETTO ST STE 11
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:SC
Mailing Address - Zip Code:29501-4418
Mailing Address - Country:US
Mailing Address - Phone:843-489-8944
Mailing Address - Fax:
Practice Address - Street 1:376 W PALMETTO ST STE 11
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:SC
Practice Address - Zip Code:29501-4418
Practice Address - Country:US
Practice Address - Phone:843-489-8944
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-12
Last Update Date:2025-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC7694101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional