Provider Demographics
NPI:1477573749
Name:GOBES, YOLANDA (MSW)
Entity Type:Individual
Prefix:MS
First Name:YOLANDA
Middle Name:
Last Name:GOBES
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:MS
Other - First Name:YOLANDA
Other - Middle Name:B
Other - Last Name:GOBES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MSW
Mailing Address - Street 1:1168 NEW BRITAIN AVE
Mailing Address - Street 2:
Mailing Address - City:WEST HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06110-2410
Mailing Address - Country:US
Mailing Address - Phone:860-232-0761
Mailing Address - Fax:860-232-1708
Practice Address - Street 1:1168 NEW BRITAIN AVE
Practice Address - Street 2:
Practice Address - City:WEST HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06110-2410
Practice Address - Country:US
Practice Address - Phone:860-232-0761
Practice Address - Fax:860-232-1708
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0008581041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT140000858CT01OtherANTHEM BC/BS PROVIDER NUM
CT000858OtherCT STATE LCSW NUMBER