Provider Demographics
NPI:1568539880
Name:YEAGER, TERRENCE W (LPC,CAC,CEAP)
Entity Type:Individual
Prefix:
First Name:TERRENCE
Middle Name:W
Last Name:YEAGER
Suffix:
Gender:M
Credentials:LPC,CAC,CEAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1330 W 26TH ST FL 2
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16508-1402
Mailing Address - Country:US
Mailing Address - Phone:814-451-2345
Mailing Address - Fax:814-451-2348
Practice Address - Street 1:1330 W 26TH ST FL 2
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16508-1402
Practice Address - Country:US
Practice Address - Phone:814-451-2345
Practice Address - Fax:814-451-2348
Is Sole Proprietor?:No
Enumeration Date:2006-11-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC000778101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional