Provider Demographics
NPI:1861911034
Name:DANIEL YEARICK, LPC, NCC - ADULT & ADOLESCENT PSYCHOTHERAPY, LLC
Entity type:Organization
Organization Name:DANIEL YEARICK, LPC, NCC - ADULT & ADOLESCENT PSYCHOTHERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:YEARICK
Authorized Official - Suffix:
Authorized Official - Credentials:MS, LPC-S
Authorized Official - Phone:828-456-4522
Mailing Address - Street 1:PO BOX 509
Mailing Address - Street 2:
Mailing Address - City:WAYNESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28786-0509
Mailing Address - Country:US
Mailing Address - Phone:828-456-4588
Mailing Address - Fax:
Practice Address - Street 1:166 BRANNER AVE STE B
Practice Address - Street 2:
Practice Address - City:WAYNESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28786-3244
Practice Address - Country:US
Practice Address - Phone:828-456-4588
Practice Address - Fax:828-456-4588
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-19
Last Update Date:2017-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCS2850101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty