Provider Demographics
NPI:1811291131
Name:TATE, YVONNE B (PHD, LPC, BCN)
Entity type:Individual
Prefix:DR
First Name:YVONNE
Middle Name:B
Last Name:TATE
Suffix:
Gender:F
Credentials:PHD, LPC, BCN
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 771
Mailing Address - Street 2:
Mailing Address - City:INDIAN HILLS
Mailing Address - State:CO
Mailing Address - Zip Code:80454-0771
Mailing Address - Country:US
Mailing Address - Phone:303-968-4048
Mailing Address - Fax:303-301-8342
Practice Address - Street 1:7500 W MISSISSIPPI AVE
Practice Address - Street 2:SUITE B-160
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80226-4550
Practice Address - Country:US
Practice Address - Phone:303-968-4048
Practice Address - Fax:303-301-8342
Is Sole Proprietor?:No
Enumeration Date:2010-12-29
Last Update Date:2012-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO5243101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional