Provider Demographics
NPI:1821394677
Name:MICHELLE MENDEZ-YOUELL
Entity Type:Organization
Organization Name:MICHELLE MENDEZ-YOUELL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PSYCHOTHERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:DIANE
Authorized Official - Last Name:MENDEZ-YOUELL
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW, LCAS
Authorized Official - Phone:828-545-9987
Mailing Address - Street 1:24 WOODROW AVE
Mailing Address - Street 2:ASHEVILLE, NC 28801
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28801-1700
Mailing Address - Country:US
Mailing Address - Phone:828-545-9987
Mailing Address - Fax:
Practice Address - Street 1:333 GASHES CREEK RD STE A
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28803-9405
Practice Address - Country:US
Practice Address - Phone:828-484-1320
Practice Address - Fax:828-490-1744
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-26
Last Update Date:2011-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0068611041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2853678Medicare PIN