Provider Demographics
NPI:1790344281
Name:YEAREGO PROFESSIONAL COUNSELING
Entity Type:Organization
Organization Name:YEAREGO PROFESSIONAL COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:LAUREN
Authorized Official - Middle Name:
Authorized Official - Last Name:YEAREGO
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LPC
Authorized Official - Phone:586-651-1575
Mailing Address - Street 1:81 INDIANWOOD RD STE 2
Mailing Address - Street 2:
Mailing Address - City:LAKE ORION
Mailing Address - State:MI
Mailing Address - Zip Code:48362-1595
Mailing Address - Country:US
Mailing Address - Phone:586-651-1575
Mailing Address - Fax:
Practice Address - Street 1:81 INDIANWOOD RD STE 2
Practice Address - Street 2:
Practice Address - City:LAKE ORION
Practice Address - State:MI
Practice Address - Zip Code:48362-1595
Practice Address - Country:US
Practice Address - Phone:586-651-1575
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-10
Last Update Date:2019-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health