Provider Demographics
NPI:1104235951
Name:YEATES CONSULTING ,LLC
Entity type:Organization
Organization Name:YEATES CONSULTING ,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:L
Authorized Official - Last Name:YEATES
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:662-328-3110
Mailing Address - Street 1:39 MAID MARION CIR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:MS
Mailing Address - Zip Code:39705-3024
Mailing Address - Country:US
Mailing Address - Phone:662-328-3110
Mailing Address - Fax:662-328-3135
Practice Address - Street 1:104 BRICKERTON ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:MS
Practice Address - Zip Code:39701-3608
Practice Address - Country:US
Practice Address - Phone:662-328-3110
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-06
Last Update Date:2014-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS1835251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health