Provider Demographics
NPI:1225603947
Name:YATES, MARIA FLORA (LCPC)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:FLORA
Last Name:YATES
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:196 N RIDING RD
Mailing Address - Street 2:
Mailing Address - City:KALISPELL
Mailing Address - State:MT
Mailing Address - Zip Code:59901-2525
Mailing Address - Country:US
Mailing Address - Phone:406-530-8484
Mailing Address - Fax:
Practice Address - Street 1:196 N RIDING RD
Practice Address - Street 2:
Practice Address - City:KALISPELL
Practice Address - State:MT
Practice Address - Zip Code:59901-2525
Practice Address - Country:US
Practice Address - Phone:406-871-5380
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-25
Last Update Date:2021-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTBBH-LCPC-LIC-48898101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional