Provider Demographics
NPI:1467692384
Name:MOORE-LINDSEY, YAKIMA (MSW, NCACII, CACII)
Entity Type:Individual
Prefix:
First Name:YAKIMA
Middle Name:
Last Name:MOORE-LINDSEY
Suffix:
Gender:F
Credentials:MSW, NCACII, CACII
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 16708
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28816-0708
Mailing Address - Country:US
Mailing Address - Phone:828-254-5356
Mailing Address - Fax:828-259-5384
Practice Address - Street 1:2 COMPTON DR
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28806-2054
Practice Address - Country:US
Practice Address - Phone:828-254-5356
Practice Address - Fax:828-259-5384
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-05
Last Update Date:2009-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC09021743245S0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3245S0500XResidential Treatment FacilitiesSubstance Abuse Rehabilitation FacilitySubstance Abuse Treatment, Children
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC0902174OtherSCAADAC CERTIFICATION COMMISSION