Provider Demographics
NPI:1396842274
Name:YEHLING, THERASA (LCSW)
Entity Type:Individual
Prefix:MS
First Name:THERASA
Middle Name:
Last Name:YEHLING
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MRS
Other - First Name:THERASA
Other - Middle Name:
Other - Last Name:ZITO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:923 BROOKFIELD RD
Mailing Address - Street 2:
Mailing Address - City:ROCKFORD
Mailing Address - State:IL
Mailing Address - Zip Code:61107-3631
Mailing Address - Country:US
Mailing Address - Phone:815-494-7338
Mailing Address - Fax:847-850-8181
Practice Address - Street 1:923 BROOKFIELD RD
Practice Address - Street 2:
Practice Address - City:ROCKFORD
Practice Address - State:IL
Practice Address - Zip Code:61107-3631
Practice Address - Country:US
Practice Address - Phone:815-494-7338
Practice Address - Fax:847-850-8181
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2017-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490110901041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical