Provider Demographics
NPI:1396891149
Name:YEAW, JOHN DAVID ANDREW (PSYD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:DAVID ANDREW
Last Name:YEAW
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2020 N ACADEMY BLVD STE 276
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80909-1567
Mailing Address - Country:US
Mailing Address - Phone:719-725-7761
Mailing Address - Fax:
Practice Address - Street 1:2020 N ACADEMY BLVD STE 276
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80909-1567
Practice Address - Country:US
Practice Address - Phone:719-425-9673
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-26
Last Update Date:2025-06-11
Deactivation Date:2025-04-23
Deactivation Code:
Reactivation Date:2025-06-11
Provider Licenses
StateLicense IDTaxonomies
TX32430103TC0700X
COPSY.0005694103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical