Provider Demographics
NPI:1205662707
Name:YANNEY, BERNADINE
Entity type:Individual
Prefix:
First Name:BERNADINE
Middle Name:
Last Name:YANNEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6364 BAYBERRY CT
Mailing Address - Street 2:
Mailing Address - City:ELKRIDGE
Mailing Address - State:MD
Mailing Address - Zip Code:21075-6922
Mailing Address - Country:US
Mailing Address - Phone:301-573-9350
Mailing Address - Fax:
Practice Address - Street 1:1908 N WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21213-1410
Practice Address - Country:US
Practice Address - Phone:301-573-9350
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-11
Last Update Date:2024-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)