Provider Demographics
NPI:1245724251
Name:STERLING YARD, INC.
Entity type:Organization
Organization Name:STERLING YARD, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIR OF BEHAVIORAL HEALTH SERVICES
Authorized Official - Prefix:DR
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:ANDREW
Authorized Official - Last Name:MARTIN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, LPC, LMFT
Authorized Official - Phone:479-263-7567
Mailing Address - Street 1:PO BOX 8902
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72703-0016
Mailing Address - Country:US
Mailing Address - Phone:479-263-7567
Mailing Address - Fax:
Practice Address - Street 1:1200 W WALNUT ST STE B1100
Practice Address - Street 2:
Practice Address - City:ROGERS
Practice Address - State:AR
Practice Address - Zip Code:72756-3562
Practice Address - Country:US
Practice Address - Phone:479-263-7567
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-22
Last Update Date:2018-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARP0610054101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty