Provider Demographics
NPI:1245822741
Name:YUELYS, NICOLETTA CASSANDRA
Entity type:Individual
Prefix:
First Name:NICOLETTA
Middle Name:CASSANDRA
Last Name:YUELYS
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 1:13 ROCKLEIGH RD
Mailing Address - Street 2:
Mailing Address - City:ROCKLEIGH
Mailing Address - State:NJ
Mailing Address - Zip Code:07647-2705
Mailing Address - Country:US
Mailing Address - Phone:201-388-7217
Mailing Address - Fax:
Practice Address - Street 1:80 MAIN ST STE 410
Practice Address - Street 2:
Practice Address - City:WEST ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07052-5441
Practice Address - Country:US
Practice Address - Phone:856-772-5809
Practice Address - Fax:856-772-5852
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-05
Last Update Date:2021-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical