Provider Demographics
NPI:1821660291
Name:YATES, MARY BETH (LCSW)
Entity Type:Individual
Prefix:
First Name:MARY BETH
Middle Name:
Last Name:YATES
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 1:4766 AU SABLE DR
Mailing Address - Street 2:
Mailing Address - City:GIBSONIA
Mailing Address - State:PA
Mailing Address - Zip Code:15044-8348
Mailing Address - Country:US
Mailing Address - Phone:412-292-6171
Mailing Address - Fax:
Practice Address - Street 1:4766 AU SABLE DR
Practice Address - Street 2:
Practice Address - City:GIBSONIA
Practice Address - State:PA
Practice Address - Zip Code:15044-8348
Practice Address - Country:US
Practice Address - Phone:412-292-6171
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-14
Last Update Date:2021-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0215121041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical