Provider Demographics
NPI:1699229971
Name:YATES, ERIN (CSAC, CADC)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:
Last Name:YATES
Suffix:
Gender:F
Credentials:CSAC, CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 698
Mailing Address - Street 2:
Mailing Address - City:SAULT SAINTE MARIE
Mailing Address - State:MI
Mailing Address - Zip Code:49783-0698
Mailing Address - Country:US
Mailing Address - Phone:920-639-4563
Mailing Address - Fax:
Practice Address - Street 1:2655 ASHMUN ST
Practice Address - Street 2:
Practice Address - City:SAULT SAINTE MARIE
Practice Address - State:MI
Practice Address - Zip Code:49783-3711
Practice Address - Country:US
Practice Address - Phone:906-632-2522
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-04
Last Update Date:2017-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI16028101YA0400X
WI101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)