Provider Demographics
NPI:1609179365
Name:YARNS, JENNIFER LYNN (MS)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:LYNN
Last Name:YARNS
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:YARNS
Other - Last Name:YOUNGBLOOD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS
Mailing Address - Street 1:7561 MAIN ST
Mailing Address - Street 2:SUITE 425
Mailing Address - City:RALSTON
Mailing Address - State:NE
Mailing Address - Zip Code:68127-3981
Mailing Address - Country:US
Mailing Address - Phone:403-709-0417
Mailing Address - Fax:
Practice Address - Street 1:7561 MAIN ST
Practice Address - Street 2:SUITE 425
Practice Address - City:RALSTON
Practice Address - State:NE
Practice Address - Zip Code:68127-3981
Practice Address - Country:US
Practice Address - Phone:403-709-0417
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-17
Last Update Date:2010-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE565101YA0400X
NE2215101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)