Provider Demographics
NPI:1366458564
Name:WOODRUFF, YVETTE (MA LPC CAADC)
Entity Type:Individual
Prefix:
First Name:YVETTE
Middle Name:
Last Name:WOODRUFF
Suffix:
Gender:F
Credentials:MA LPC CAADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:51424 VAN DYKE AVENUE SUITE 7
Mailing Address - Street 2:
Mailing Address - City:SHELBY TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48316
Mailing Address - Country:US
Mailing Address - Phone:586-753-0405
Mailing Address - Fax:586-753-0404
Practice Address - Street 1:51424 VAN DYKE AVENUE SUITE 7
Practice Address - Street 2:
Practice Address - City:SHELBYTOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48316
Practice Address - Country:US
Practice Address - Phone:248-763-6215
Practice Address - Fax:248-288-1362
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2016-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401004434101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor