Provider Demographics
NPI:1164297438
Name:YATES, LISA KAYE (LCMHC-A)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:KAYE
Last Name:YATES
Suffix:
Gender:F
Credentials:LCMHC-A
Other - Prefix:
Other - First Name:LISA
Other - Middle Name:KAYE
Other - Last Name:HONEYCUTT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1950 STERLING HILL DR
Mailing Address - Street 2:
Mailing Address - City:FUQUAY VARINA
Mailing Address - State:NC
Mailing Address - Zip Code:27526-5302
Mailing Address - Country:US
Mailing Address - Phone:919-422-4754
Mailing Address - Fax:
Practice Address - Street 1:2201 CANDUN DR
Practice Address - Street 2:
Practice Address - City:APEX
Practice Address - State:NC
Practice Address - Zip Code:27523-6412
Practice Address - Country:US
Practice Address - Phone:919-909-7959
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-16
Last Update Date:2023-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA19118101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health