Provider Demographics
NPI:1831746429
Name:YERTON, ROBERT CONNER (LCSW)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:CONNER
Last Name:YERTON
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 S. BOADVIEW ST.
Mailing Address - Street 2:STE EANDF
Mailing Address - City:GREENBRIER
Mailing Address - State:AR
Mailing Address - Zip Code:72058-9601
Mailing Address - Country:US
Mailing Address - Phone:501-679-0232
Mailing Address - Fax:833-373-0348
Practice Address - Street 1:8 S BROADVIEW ST STE EANDF
Practice Address - Street 2:
Practice Address - City:GREENBRIER
Practice Address - State:AR
Practice Address - Zip Code:72058-9601
Practice Address - Country:US
Practice Address - Phone:501-679-0232
Practice Address - Fax:833-373-0348
Is Sole Proprietor?:No
Enumeration Date:2019-08-20
Last Update Date:2022-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR9552-C1041C0700X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR235841795Medicaid