Provider Demographics
NPI:1811049109
Name:JOAN M YELANJIAN
Entity type:Organization
Organization Name:JOAN M YELANJIAN
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOAN
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:YELANJIAN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:414-762-7297
Mailing Address - Street 1:625 MICHIGAN AVE
Mailing Address - Street 2:
Mailing Address - City:SOUTH MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53172-2724
Mailing Address - Country:US
Mailing Address - Phone:414-762-7297
Mailing Address - Fax:
Practice Address - Street 1:625 MICHIGAN AVE
Practice Address - Street 2:
Practice Address - City:SOUTH MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53172-2724
Practice Address - Country:US
Practice Address - Phone:414-762-7297
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-17
Last Update Date:2008-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI23161231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty