Provider Demographics
NPI:1912640640
Name:BELIZAIRE, YULANDA KIM (LPC ASSOCIATE)
Entity type:Individual
Prefix:
First Name:YULANDA
Middle Name:KIM
Last Name:BELIZAIRE
Suffix:
Gender:F
Credentials:LPC ASSOCIATE
Other - Prefix:
Other - First Name:YULANDA
Other - Middle Name:KIM
Other - Last Name:JACKSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC ASSOCIATE
Mailing Address - Street 1:8308 DAISY CUTTER XING
Mailing Address - Street 2:
Mailing Address - City:GEORGETOWN
Mailing Address - State:TX
Mailing Address - Zip Code:78626-4768
Mailing Address - Country:US
Mailing Address - Phone:571-294-4031
Mailing Address - Fax:
Practice Address - Street 1:8308 DAISY CUTTER XING
Practice Address - Street 2:
Practice Address - City:GEORGETOWN
Practice Address - State:TX
Practice Address - Zip Code:78626-4768
Practice Address - Country:US
Practice Address - Phone:571-294-4031
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-20
Last Update Date:2022-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX84809101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health