Provider Demographics
NPI:1760954770
Name:YELLOW WOOD COUNSELING, LLC
Entity Type:Organization
Organization Name:YELLOW WOOD COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:
Authorized Official - Last Name:SKAGGS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:270-287-3351
Mailing Address - Street 1:1005 E 15TH AVE STE E
Mailing Address - Street 2:
Mailing Address - City:BOWLING GREEN
Mailing Address - State:KY
Mailing Address - Zip Code:42104-3002
Mailing Address - Country:US
Mailing Address - Phone:270-287-3351
Mailing Address - Fax:
Practice Address - Street 1:1005 E 15TH AVE STE E
Practice Address - Street 2:
Practice Address - City:BOWLING GREEN
Practice Address - State:KY
Practice Address - Zip Code:42104-3002
Practice Address - Country:US
Practice Address - Phone:270-287-3351
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-02
Last Update Date:2019-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty