Provider Demographics
NPI:1710004742
Name:YARD, MINDY L (LCPC)
Entity Type:Individual
Prefix:
First Name:MINDY
Middle Name:L
Last Name:YARD
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:MINDY
Other - Middle Name:L
Other - Last Name:BUCEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCPC
Mailing Address - Street 1:201 BREEZEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:HANOVER
Mailing Address - State:PA
Mailing Address - Zip Code:17331-9361
Mailing Address - Country:US
Mailing Address - Phone:443-536-1277
Mailing Address - Fax:
Practice Address - Street 1:59 KATE WAGNER ROAD
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:MD
Practice Address - Zip Code:21157
Practice Address - Country:US
Practice Address - Phone:443-244-8686
Practice Address - Fax:443-244-8886
Is Sole Proprietor?:No
Enumeration Date:2007-03-23
Last Update Date:2009-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC2713101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD615501400Medicaid