Provider Demographics
NPI:1689992240
Name:JAMES, YVONNE MICHELLE (LCAS)
Entity Type:Individual
Prefix:MRS
First Name:YVONNE
Middle Name:MICHELLE
Last Name:JAMES
Suffix:
Gender:F
Credentials:LCAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3753 HORSESHOE FARM ST
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27610-6425
Mailing Address - Country:US
Mailing Address - Phone:919-862-6981
Mailing Address - Fax:
Practice Address - Street 1:1100 NAVAHO DR
Practice Address - Street 2:SUITE 125
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27609-7319
Practice Address - Country:US
Practice Address - Phone:919-862-6981
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-06
Last Update Date:2010-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1622101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)