Provider Demographics
NPI:1023023983
Name:YATES, KINBERLY SUE (LISW)
Entity Type:Individual
Prefix:
First Name:KINBERLY
Middle Name:SUE
Last Name:YATES
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5726 TURNER LN
Mailing Address - Street 2:
Mailing Address - City:HILLIARD
Mailing Address - State:OH
Mailing Address - Zip Code:43026-9013
Mailing Address - Country:US
Mailing Address - Phone:614-529-2776
Mailing Address - Fax:
Practice Address - Street 1:1301 N HIGH ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43201-2460
Practice Address - Country:US
Practice Address - Phone:614-299-6600
Practice Address - Fax:614-421-3111
Is Sole Proprietor?:No
Enumeration Date:2006-07-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI 82341041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical