Provider Demographics
NPI:1063147916
Name:MATHIS, YOLANDA (LMSW)
Entity type:Individual
Prefix:
First Name:YOLANDA
Middle Name:
Last Name:MATHIS
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8820 REX CT
Mailing Address - Street 2:
Mailing Address - City:WAXAHACHIE
Mailing Address - State:TX
Mailing Address - Zip Code:75167-0109
Mailing Address - Country:US
Mailing Address - Phone:214-329-7671
Mailing Address - Fax:
Practice Address - Street 1:8820 REX CT
Practice Address - Street 2:
Practice Address - City:WAXAHACHIE
Practice Address - State:TX
Practice Address - Zip Code:75167-0109
Practice Address - Country:US
Practice Address - Phone:214-329-7671
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-22
Last Update Date:2022-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX103297104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker