Provider Demographics
NPI:1861869992
Name:DUSTON, MIRIAM MCBRAYER YELTON (LCSW)
Entity type:Individual
Prefix:MS
First Name:MIRIAM
Middle Name:MCBRAYER YELTON
Last Name:DUSTON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:MIRIAM
Other - Middle Name:MCBRAYER
Other - Last Name:YELTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ASW
Mailing Address - Street 1:2750 SUTTERVILLE RD
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95820-1024
Mailing Address - Country:US
Mailing Address - Phone:916-290-8232
Mailing Address - Fax:916-736-1072
Practice Address - Street 1:2750 SUTTERVILLE RD
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95820-1024
Practice Address - Country:US
Practice Address - Phone:916-290-8232
Practice Address - Fax:916-736-1072
Is Sole Proprietor?:No
Enumeration Date:2015-08-24
Last Update Date:2019-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA89000104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker