Provider Demographics
NPI:1013186782
Name:YATES, DAWN (MSW LSW)
Entity Type:Individual
Prefix:
First Name:DAWN
Middle Name:
Last Name:YATES
Suffix:
Gender:F
Credentials:MSW LSW
Other - Prefix:
Other - First Name:DAWN
Other - Middle Name:
Other - Last Name:ORTEGA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:100 ANCHOR RD STE 2
Mailing Address - Street 2:
Mailing Address - City:MICHIGAN CITY
Mailing Address - State:IN
Mailing Address - Zip Code:46360-2802
Mailing Address - Country:US
Mailing Address - Phone:219-608-8357
Mailing Address - Fax:833-249-9175
Practice Address - Street 1:100 ANCHOR RD STE 2
Practice Address - Street 2:
Practice Address - City:MICHIGAN CITY
Practice Address - State:IN
Practice Address - Zip Code:46360-2802
Practice Address - Country:US
Practice Address - Phone:219-608-8357
Practice Address - Fax:833-249-9175
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-26
Last Update Date:2023-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN33009114A104100000X
104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker