Provider Demographics
NPI:1639630213
Name:HUMPHERY, YOHANCE (LCSW)
Entity Type:Individual
Prefix:
First Name:YOHANCE
Middle Name:
Last Name:HUMPHERY
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 1:975 KIRMAN AVE
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89502-0997
Mailing Address - Country:US
Mailing Address - Phone:775-786-7200
Mailing Address - Fax:
Practice Address - Street 1:350 CAPITOL HILL AVE
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89502-2923
Practice Address - Country:US
Practice Address - Phone:775-326-2965
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-27
Last Update Date:2019-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLCSW155101041C0700X
COCSW.099245521041C0700X
AKCSW-12611041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical