Provider Demographics
NPI:1881408573
Name:LINDA YEAROUS PSYCHOTHERAPY PLLC
Entity type:Organization
Organization Name:LINDA YEAROUS PSYCHOTHERAPY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER AND CLINICIAN
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:AJ SLITER
Authorized Official - Last Name:YEAROUS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:701-203-3442
Mailing Address - Street 1:PO BOX 7236
Mailing Address - Street 2:
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59807-7236
Mailing Address - Country:US
Mailing Address - Phone:406-471-0282
Mailing Address - Fax:
Practice Address - Street 1:101 E BROADWAY ST STE 312
Practice Address - Street 2:
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59802-4589
Practice Address - Country:US
Practice Address - Phone:406-471-0282
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-04
Last Update Date:2025-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT200017352Medicaid