Provider Demographics
NPI:1508489576
Name:YEHL, NICHOLAS ADAM (LSW)
Entity Type:Individual
Prefix:MR
First Name:NICHOLAS
Middle Name:ADAM
Last Name:YEHL
Suffix:
Gender:M
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4016 N EMERSON AVE
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46226-4634
Mailing Address - Country:US
Mailing Address - Phone:812-690-1735
Mailing Address - Fax:
Practice Address - Street 1:110 S INDIANA ST
Practice Address - Street 2:
Practice Address - City:GREENCASTLE
Practice Address - State:IN
Practice Address - Zip Code:46135-1697
Practice Address - Country:US
Practice Address - Phone:812-558-0519
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-25
Last Update Date:2020-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN33008424A101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor