Provider Demographics
NPI:1629748637
Name:WILSON, YOLANDA DANELLE (LMSW)
Entity Type:Individual
Prefix:MS
First Name:YOLANDA
Middle Name:DANELLE
Last Name:WILSON
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2419 SE MADISON ST
Mailing Address - Street 2:
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66605-1152
Mailing Address - Country:US
Mailing Address - Phone:785-580-8598
Mailing Address - Fax:
Practice Address - Street 1:2419 SE MADISON ST
Practice Address - Street 2:
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66605-1152
Practice Address - Country:US
Practice Address - Phone:785-580-8598
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-20
Last Update Date:2021-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS11517104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker