Provider Demographics
NPI:1558869701
Name:YEARSLEY, RAYCHEL CHRISTINE (MS, LPC-INTERN)
Entity Type:Individual
Prefix:
First Name:RAYCHEL
Middle Name:CHRISTINE
Last Name:YEARSLEY
Suffix:
Gender:F
Credentials:MS, LPC-INTERN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9400 N CENTRAL EXPY STE 150
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75231-5033
Mailing Address - Country:US
Mailing Address - Phone:469-341-9133
Mailing Address - Fax:214-360-9366
Practice Address - Street 1:9400 N CENTRAL EXPY STE 150
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-5033
Practice Address - Country:US
Practice Address - Phone:469-341-9133
Practice Address - Fax:214-360-9366
Is Sole Proprietor?:No
Enumeration Date:2018-01-23
Last Update Date:2018-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX75030101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional