Provider Demographics
NPI:1477630457
Name:YEAROUT, LINDA (LCMFT)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:
Last Name:YEAROUT
Suffix:
Gender:F
Credentials:LCMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1601 W 16TH ST
Mailing Address - Street 2:
Mailing Address - City:WELLINGTON
Mailing Address - State:KS
Mailing Address - Zip Code:67152-8125
Mailing Address - Country:US
Mailing Address - Phone:620-326-7448
Mailing Address - Fax:
Practice Address - Street 1:1601 W 16TH ST
Practice Address - Street 2:
Practice Address - City:WELLINGTON
Practice Address - State:KS
Practice Address - Zip Code:67152-8125
Practice Address - Country:US
Practice Address - Phone:620-326-7448
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS295106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100229020AMedicaid
KS829984OtherBCBS