Provider Demographics
NPI:1134867500
Name:YOBE, KELLIE NICOLE (MS, LBS)
Entity type:Individual
Prefix:
First Name:KELLIE
Middle Name:NICOLE
Last Name:YOBE
Suffix:
Gender:F
Credentials:MS, LBS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1041 PLUM ST
Mailing Address - Street 2:
Mailing Address - City:SHARON
Mailing Address - State:PA
Mailing Address - Zip Code:16146-3084
Mailing Address - Country:US
Mailing Address - Phone:724-931-2320
Mailing Address - Fax:
Practice Address - Street 1:194 E STATE ST
Practice Address - Street 2:
Practice Address - City:SHARON
Practice Address - State:PA
Practice Address - Zip Code:16146-1701
Practice Address - Country:US
Practice Address - Phone:724-981-9900
Practice Address - Fax:724-981-0868
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-25
Last Update Date:2022-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PABH002006101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty