Provider Demographics
NPI:1720325962
Name:YAWN, CAROLYN ANNE (MA, LMFT)
Entity Type:Individual
Prefix:
First Name:CAROLYN
Middle Name:ANNE
Last Name:YAWN
Suffix:
Gender:F
Credentials:MA, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 5144
Mailing Address - Street 2:
Mailing Address - City:ARCATA
Mailing Address - State:CA
Mailing Address - Zip Code:95518-5144
Mailing Address - Country:US
Mailing Address - Phone:707-633-3692
Mailing Address - Fax:
Practice Address - Street 1:770 10TH ST
Practice Address - Street 2:
Practice Address - City:ARCATA
Practice Address - State:CA
Practice Address - Zip Code:95521-6210
Practice Address - Country:US
Practice Address - Phone:707-826-8610
Practice Address - Fax:707-826-8623
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-08
Last Update Date:2024-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALMFT107833101YM0800X, 106H00000X, 106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health