Provider Demographics
NPI:1962887422
Name:YALE, LOUISE (LPC)
Entity type:Individual
Prefix:
First Name:LOUISE
Middle Name:
Last Name:YALE
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1015 REMINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:THOMASVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:31792-4832
Mailing Address - Country:US
Mailing Address - Phone:229-224-5049
Mailing Address - Fax:229-225-5288
Practice Address - Street 1:1102 SMITH AVE
Practice Address - Street 2:SUITE K
Practice Address - City:THOMASVILLE
Practice Address - State:GA
Practice Address - Zip Code:31792-5739
Practice Address - Country:US
Practice Address - Phone:229-224-4335
Practice Address - Fax:229-225-4374
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-27
Last Update Date:2015-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC008517101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional