Provider Demographics
NPI:1083352330
Name:YATES, RAYMON CLYDE JR (MA, NCC, LPC-A)
Entity Type:Individual
Prefix:MR
First Name:RAYMON
Middle Name:CLYDE
Last Name:YATES
Suffix:JR
Gender:M
Credentials:MA, NCC, LPC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1154 RUSTLING WIND LN
Mailing Address - Street 2:
Mailing Address - City:LEAGUE CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77573-3052
Mailing Address - Country:US
Mailing Address - Phone:832-289-0499
Mailing Address - Fax:
Practice Address - Street 1:6021 FAIRMONT PKWY STE 200
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:TX
Practice Address - Zip Code:77505-4511
Practice Address - Country:US
Practice Address - Phone:281-769-2238
Practice Address - Fax:281-769-2164
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-26
Last Update Date:2022-05-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX88608101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional