Provider Demographics
NPI:1316359250
Name:YEMIOLA, COURTNEY M (NCC)
Entity type:Individual
Prefix:MRS
First Name:COURTNEY
Middle Name:M
Last Name:YEMIOLA
Suffix:
Gender:F
Credentials:NCC
Other - Prefix:MISS
Other - First Name:COURTNEY
Other - Middle Name:M
Other - Last Name:BUTLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:299 HOMESTEAD DR
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27292-8350
Mailing Address - Country:US
Mailing Address - Phone:704-600-5945
Mailing Address - Fax:
Practice Address - Street 1:2000 AHKOVAK ST.
Practice Address - Street 2:
Practice Address - City:BARROW
Practice Address - State:AK
Practice Address - Zip Code:99723
Practice Address - Country:US
Practice Address - Phone:907-852-0263
Practice Address - Fax:907-852-0463
Is Sole Proprietor?:No
Enumeration Date:2014-05-27
Last Update Date:2020-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC330281101YM0800X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health