Provider Demographics
NPI:1003966383
Name:YADKIN COUNTY SCHOOLS
Entity Type:Organization
Organization Name:YADKIN COUNTY SCHOOLS
Other - Org Name:YADKIN COUNTY ADVP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADVP DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:TERRI
Authorized Official - Middle Name:MIKLES
Authorized Official - Last Name:VESTAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:3363-367-5187
Mailing Address - Street 1:121 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:YADKINVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27055-7725
Mailing Address - Country:US
Mailing Address - Phone:336-367-5187
Mailing Address - Fax:336-367-3062
Practice Address - Street 1:3801B RIVER ROAD
Practice Address - Street 2:
Practice Address - City:BOONVILLE
Practice Address - State:NC
Practice Address - Zip Code:27011-8341
Practice Address - Country:US
Practice Address - Phone:336-367-5187
Practice Address - Fax:336-367-3062
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCMHL-099-002103TM1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TM1800XBehavioral Health & Social Service ProvidersPsychologistIntellectual & Developmental DisabilitiesGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3408907Medicaid