Provider Demographics
NPI:1487463840
Name:STEPHANIE YANCEY, LCSW, PLLC
Entity type:Organization
Organization Name:STEPHANIE YANCEY, LCSW, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LCSW
Authorized Official - Prefix:
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:YANCEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-336-3246
Mailing Address - Street 1:10764 LIMBURG FORKS RD
Mailing Address - Street 2:
Mailing Address - City:CARTHAGE
Mailing Address - State:NY
Mailing Address - Zip Code:13619-3102
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:10764 LIMBURG FORKS RD
Practice Address - Street 2:
Practice Address - City:CARTHAGE
Practice Address - State:NY
Practice Address - Zip Code:13619-3102
Practice Address - Country:US
Practice Address - Phone:714-336-3246
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-31
Last Update Date:2024-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty