Provider Demographics
NPI:1316006273
Name:YANDLE, JAMES MCKAMEY (LCSW)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:MCKAMEY
Last Name:YANDLE
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2102 MACY DR
Mailing Address - Street 2:
Mailing Address - City:ROSWELL
Mailing Address - State:GA
Mailing Address - Zip Code:30076-6340
Mailing Address - Country:US
Mailing Address - Phone:770-993-2897
Mailing Address - Fax:770-587-4889
Practice Address - Street 1:2102 MACY DR
Practice Address - Street 2:
Practice Address - City:ROSWELL
Practice Address - State:GA
Practice Address - Zip Code:30076-6340
Practice Address - Country:US
Practice Address - Phone:770-993-2897
Practice Address - Fax:770-587-4889
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0010201041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical