Provider Demographics
NPI:1407213119
Name:YANKOVIAK, STEVEN ARTHUR (LLPC)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:ARTHUR
Last Name:YANKOVIAK
Suffix:
Gender:M
Credentials:LLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 W ALLEGAN ST
Mailing Address - Street 2:
Mailing Address - City:OTSEGO
Mailing Address - State:MI
Mailing Address - Zip Code:49078-1115
Mailing Address - Country:US
Mailing Address - Phone:269-692-2100
Mailing Address - Fax:
Practice Address - Street 1:115 W ALLEGAN ST
Practice Address - Street 2:
Practice Address - City:OTSEGO
Practice Address - State:MI
Practice Address - Zip Code:49078-1115
Practice Address - Country:US
Practice Address - Phone:269-692-2100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-26
Last Update Date:2016-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401015096101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional