Provider Demographics
NPI:1538231147
Name:YAGER, TERESA E (MA, LMHC)
Entity type:Individual
Prefix:MS
First Name:TERESA
Middle Name:E
Last Name:YAGER
Suffix:
Gender:F
Credentials:MA, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15450 SMOLAND LN NE
Mailing Address - Street 2:
Mailing Address - City:BAINBRIDGE ISLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98110-1040
Mailing Address - Country:US
Mailing Address - Phone:206-794-1211
Mailing Address - Fax:206-855-8461
Practice Address - Street 1:533 MADISON AVE N
Practice Address - Street 2:SUITE D
Practice Address - City:BAINBRIDGE ISLAND
Practice Address - State:WA
Practice Address - Zip Code:98110-1749
Practice Address - Country:US
Practice Address - Phone:206-794-1211
Practice Address - Fax:206-855-8461
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH00005094101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health