Provider Demographics
NPI:1194083634
Name:MCDONALD, YVETTE E (LCSW)
Entity type:Individual
Prefix:MRS
First Name:YVETTE
Middle Name:E
Last Name:MCDONALD
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:YVETTE
Other - Middle Name:E
Other - Last Name:MOBLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:1222 SE PORT ST LUCIE BLVD
Mailing Address - Street 2:
Mailing Address - City:PORT SAINT LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34952-5364
Mailing Address - Country:US
Mailing Address - Phone:772-361-8448
Mailing Address - Fax:844-269-6480
Practice Address - Street 1:1222 SE PORT ST LUCIE BLVD
Practice Address - Street 2:
Practice Address - City:PORT SAINT LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34952-5364
Practice Address - Country:US
Practice Address - Phone:772-361-8448
Practice Address - Fax:844-269-6480
Is Sole Proprietor?:No
Enumeration Date:2012-05-02
Last Update Date:2017-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1041C0700X
FLSW 122241041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical