Provider Demographics
NPI:1366443038
Name:YATES, RICHARD (LPC)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:
Last Name:YATES
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3001 SCENIC HWY
Mailing Address - Street 2:
Mailing Address - City:GADSDEN
Mailing Address - State:AL
Mailing Address - Zip Code:35904-3047
Mailing Address - Country:US
Mailing Address - Phone:256-546-9265
Mailing Address - Fax:256-549-0376
Practice Address - Street 1:1302 NOBLE STREET
Practice Address - Street 2:STE. 3D
Practice Address - City:ANNISTON
Practice Address - State:AL
Practice Address - Zip Code:36201-4678
Practice Address - Country:US
Practice Address - Phone:256-546-9265
Practice Address - Fax:256-549-0376
Is Sole Proprietor?:No
Enumeration Date:2005-08-03
Last Update Date:2008-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2024101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL2024OtherLPC
ALI115Medicare PIN