Provider Demographics
NPI:1326845249
Name:YANDO, CAROLLE EILEEN (ADVANCED CASAC)
Entity type:Individual
Prefix:
First Name:CAROLLE
Middle Name:EILEEN
Last Name:YANDO
Suffix:
Gender:
Credentials:ADVANCED CASAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:820 RIVER ST
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:NY
Mailing Address - Zip Code:12180-1237
Mailing Address - Country:US
Mailing Address - Phone:518-650-2966
Mailing Address - Fax:
Practice Address - Street 1:820 RIVER ST
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:NY
Practice Address - Zip Code:12180-1237
Practice Address - Country:US
Practice Address - Phone:518-650-2966
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-27
Last Update Date:2025-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY28440101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)