Provider Demographics
NPI:1417172354
Name:FERRELL, YVONNE EVERETT (LPC)
Entity Type:Individual
Prefix:MRS
First Name:YVONNE
Middle Name:EVERETT
Last Name:FERRELL
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:541 W MONTGOMERY ST
Mailing Address - Street 2:SUITE 22
Mailing Address - City:MILLEDGEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:31061-3292
Mailing Address - Country:US
Mailing Address - Phone:478-445-1290
Mailing Address - Fax:478-445-1296
Practice Address - Street 1:175 EMERY HWY
Practice Address - Street 2:
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31217-3692
Practice Address - Country:US
Practice Address - Phone:478-751-4446
Practice Address - Fax:478-751-4444
Is Sole Proprietor?:No
Enumeration Date:2007-04-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACSW000278101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
GALPC004849OtherLPC