Provider Demographics
NPI:1639786858
Name:YATES, RICHARD LEE (MS, LPC)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:LEE
Last Name:YATES
Suffix:
Gender:M
Credentials:MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 W 7TH ST
Mailing Address - Street 2:
Mailing Address - City:MC GREGOR
Mailing Address - State:TX
Mailing Address - Zip Code:76657-1616
Mailing Address - Country:US
Mailing Address - Phone:254-548-2662
Mailing Address - Fax:
Practice Address - Street 1:116 W BURLESON RD
Practice Address - Street 2:
Practice Address - City:MART
Practice Address - State:TX
Practice Address - Zip Code:76664-1107
Practice Address - Country:US
Practice Address - Phone:254-297-5767
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-30
Last Update Date:2020-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX76426101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty