Provider Demographics
NPI:1124643531
Name:YATES, JAMIELYN (MA, LLPC)
Entity type:Individual
Prefix:
First Name:JAMIELYN
Middle Name:
Last Name:YATES
Suffix:
Gender:F
Credentials:MA, LLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1801 N 31ST ST
Mailing Address - Street 2:
Mailing Address - City:SAINT JOSEPH
Mailing Address - State:MO
Mailing Address - Zip Code:64506-2131
Mailing Address - Country:US
Mailing Address - Phone:816-617-1204
Mailing Address - Fax:
Practice Address - Street 1:1801 N 31ST ST
Practice Address - Street 2:
Practice Address - City:SAINT JOSEPH
Practice Address - State:MO
Practice Address - Zip Code:64506-2131
Practice Address - Country:US
Practice Address - Phone:816-617-1204
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-11
Last Update Date:2024-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2020009341101Y00000X
MI6451019632101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor