Provider Demographics
NPI:1558553370
Name:YEATES, ANGELA L (MS, LCPC)
Entity type:Individual
Prefix:MS
First Name:ANGELA
Middle Name:L
Last Name:YEATES
Suffix:
Gender:F
Credentials:MS, LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1572 LILAC DR
Mailing Address - Street 2:
Mailing Address - City:CRYSTAL LAKE
Mailing Address - State:IL
Mailing Address - Zip Code:60014-1955
Mailing Address - Country:US
Mailing Address - Phone:815-404-3365
Mailing Address - Fax:847-368-0764
Practice Address - Street 1:2200 HUNTINGTON DR N
Practice Address - Street 2:
Practice Address - City:ALGONQUIN
Practice Address - State:IL
Practice Address - Zip Code:60102-4419
Practice Address - Country:US
Practice Address - Phone:815-404-3365
Practice Address - Fax:815-356-7139
Is Sole Proprietor?:No
Enumeration Date:2007-08-15
Last Update Date:2025-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180003737101YM0800X
IL180-003737101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health