Provider Demographics
NPI:1699845719
Name:CORDEIRO, YVONNE A (LCSW)
Entity Type:Individual
Prefix:
First Name:YVONNE
Middle Name:A
Last Name:CORDEIRO
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:429 N WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:NEVADA
Mailing Address - State:MO
Mailing Address - Zip Code:64772-2346
Mailing Address - Country:US
Mailing Address - Phone:417-667-4315
Mailing Address - Fax:417-667-4330
Practice Address - Street 1:429 N WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:NEVADA
Practice Address - State:MO
Practice Address - Zip Code:64772-2346
Practice Address - Country:US
Practice Address - Phone:417-667-4315
Practice Address - Fax:417-667-4330
Is Sole Proprietor?:No
Enumeration Date:2006-11-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO000872101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health