Provider Demographics
NPI:1235324468
Name:YATES, STEPHEN DWIGHT (MA, LMFT)
Entity Type:Individual
Prefix:MR
First Name:STEPHEN
Middle Name:DWIGHT
Last Name:YATES
Suffix:
Gender:M
Credentials:MA, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1387
Mailing Address - Street 2:
Mailing Address - City:HAYDEN
Mailing Address - State:ID
Mailing Address - Zip Code:83835-1387
Mailing Address - Country:US
Mailing Address - Phone:208-415-0299
Mailing Address - Fax:208-529-1627
Practice Address - Street 1:1270 N NORTHWOOD CENTER CT
Practice Address - Street 2:
Practice Address - City:COEUR D ALENE
Practice Address - State:ID
Practice Address - Zip Code:83814-2664
Practice Address - Country:US
Practice Address - Phone:208-769-4222
Practice Address - Fax:208-807-3782
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-11
Last Update Date:2023-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLMFT-6106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist