Provider Demographics
NPI:1548613888
Name:YEATTS, STEPHANIE BIBBY (LCMHC)
Entity Type:Individual
Prefix:MRS
First Name:STEPHANIE
Middle Name:BIBBY
Last Name:YEATTS
Suffix:
Gender:F
Credentials:LCMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:787 KENTWOOD LN
Mailing Address - Street 2:
Mailing Address - City:PISGAH FOREST
Mailing Address - State:NC
Mailing Address - Zip Code:28768-8522
Mailing Address - Country:US
Mailing Address - Phone:713-751-9242
Mailing Address - Fax:
Practice Address - Street 1:26 S BROAD ST
Practice Address - Street 2:
Practice Address - City:BREVARD
Practice Address - State:NC
Practice Address - Zip Code:28712-3791
Practice Address - Country:US
Practice Address - Phone:713-751-9242
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-21
Last Update Date:2023-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC12838101YM0800X
TX82404101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional