Provider Demographics
NPI:1356690689
Name:YATES, ROBERT D III (PHD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:D
Last Name:YATES
Suffix:III
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1010 DOWNING AVE STE 60
Mailing Address - Street 2:
Mailing Address - City:HAYS
Mailing Address - State:KS
Mailing Address - Zip Code:67601-2461
Mailing Address - Country:US
Mailing Address - Phone:785-621-4417
Mailing Address - Fax:866-473-6903
Practice Address - Street 1:1010 DOWNING AVE STE 60
Practice Address - Street 2:
Practice Address - City:HAYS
Practice Address - State:KS
Practice Address - Zip Code:67601-2461
Practice Address - Country:US
Practice Address - Phone:785-621-4417
Practice Address - Fax:866-473-6903
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-31
Last Update Date:2022-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS2318103TC0700X
KS572101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)