Provider Demographics
NPI:1235441130
Name:YATES, NATALIE DENISE (LCSW)
Entity Type:Individual
Prefix:MISS
First Name:NATALIE
Middle Name:DENISE
Last Name:YATES
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5610 HARBOR HOUSE DR
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27410-1948
Mailing Address - Country:US
Mailing Address - Phone:336-601-7511
Mailing Address - Fax:
Practice Address - Street 1:129 ALLEN ST
Practice Address - Street 2:
Practice Address - City:KERNERSVILLE
Practice Address - State:NC
Practice Address - Zip Code:27284-2940
Practice Address - Country:US
Practice Address - Phone:336-293-7406
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-08
Last Update Date:2017-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0058121041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical