Provider Demographics
NPI:1336147552
Name:YARLING, MARY LEOMA (LCSW)
Entity type:Individual
Prefix:MS
First Name:MARY
Middle Name:LEOMA
Last Name:YARLING
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:152 BROYLES RD
Mailing Address - Street 2:
Mailing Address - City:TELFORD
Mailing Address - State:TN
Mailing Address - Zip Code:37690-2133
Mailing Address - Country:US
Mailing Address - Phone:423-257-8117
Mailing Address - Fax:
Practice Address - Street 1:2 REDBUSH CT
Practice Address - Street 2:
Practice Address - City:JOHNSON CITY
Practice Address - State:TN
Practice Address - Zip Code:37601-4340
Practice Address - Country:US
Practice Address - Phone:423-283-4958
Practice Address - Fax:423-283-7135
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-12
Last Update Date:2009-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNCSW61551041C0700X
TNLSW46941041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical