Provider Demographics
NPI:1841392248
Name:YORK-ANDERSON, DOLLEAN (PHD)
Entity Type:Individual
Prefix:DR
First Name:DOLLEAN
Middle Name:
Last Name:YORK-ANDERSON
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 373
Mailing Address - Street 2:
Mailing Address - City:CARBONDALE
Mailing Address - State:IL
Mailing Address - Zip Code:62903-0373
Mailing Address - Country:US
Mailing Address - Phone:618-549-7611
Mailing Address - Fax:618-549-7611
Practice Address - Street 1:231 W MAIN ST
Practice Address - Street 2:
Practice Address - City:CARBONDALE
Practice Address - State:IL
Practice Address - Zip Code:62901-2948
Practice Address - Country:US
Practice Address - Phone:618-549-7611
Practice Address - Fax:618-549-7611
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health