Provider Demographics
NPI:1053324137
Name:YUELLS, DAVID H (LICSW)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:H
Last Name:YUELLS
Suffix:
Gender:M
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37 BALLSTON AVE
Mailing Address - Street 2:
Mailing Address - City:PAWTUCKET
Mailing Address - State:RI
Mailing Address - Zip Code:02861-2715
Mailing Address - Country:US
Mailing Address - Phone:401-527-6495
Mailing Address - Fax:401-365-1044
Practice Address - Street 1:84 HARRIS ST
Practice Address - Street 2:
Practice Address - City:PAWTUCKET
Practice Address - State:RI
Practice Address - Zip Code:02861-1719
Practice Address - Country:US
Practice Address - Phone:401-475-5075
Practice Address - Fax:401-365-1044
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-13
Last Update Date:2021-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIISW002711041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA105770OtherMA STATE LICENSE
RIISW00271OtherRI LICENSE #