Provider Demographics
NPI:1619527645
Name:FROM THE DESK OF DR. YANCEY LLC
Entity Type:Organization
Organization Name:FROM THE DESK OF DR. YANCEY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL SPECIALIST
Authorized Official - Prefix:DR
Authorized Official - First Name:TIFFINEE
Authorized Official - Middle Name:
Authorized Official - Last Name:YANCEY
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:757-717-9569
Mailing Address - Street 1:PO BOX 5354
Mailing Address - Street 2:
Mailing Address - City:SUFFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23435-0354
Mailing Address - Country:US
Mailing Address - Phone:888-663-2475
Mailing Address - Fax:888-663-2475
Practice Address - Street 1:4897 BENNETTS PASTURE RD #5354
Practice Address - Street 2:
Practice Address - City:SUFFOLK
Practice Address - State:VA
Practice Address - Zip Code:23435-2689
Practice Address - Country:US
Practice Address - Phone:888-663-2475
Practice Address - Fax:888-663-2475
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-11
Last Update Date:2024-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
No251S00000XAgenciesCommunity/Behavioral Health
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental HealthGroup - Single Specialty