Provider Demographics
NPI:1578702254
Name:YEATS, DAVID A (LCSW)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:A
Last Name:YEATS
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:711 WALNUT ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80302-5362
Mailing Address - Country:US
Mailing Address - Phone:303-444-8064
Mailing Address - Fax:303-444-8180
Practice Address - Street 1:711 WALNUT ST
Practice Address - Street 2:SUITE 200
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80302-5362
Practice Address - Country:US
Practice Address - Phone:303-335-9170
Practice Address - Fax:303-444-8064
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-19
Last Update Date:2010-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO9892131041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical