Provider Demographics
NPI:1972609402
Name:YATES, BERNARD ANTHONY (LCSW-C)
Entity type:Individual
Prefix:MR
First Name:BERNARD
Middle Name:ANTHONY
Last Name:YATES
Suffix:
Gender:M
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:458 DOE MEADOW DR
Mailing Address - Street 2:
Mailing Address - City:OWINGS MILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21117-1366
Mailing Address - Country:US
Mailing Address - Phone:410-902-8613
Mailing Address - Fax:410-902-1149
Practice Address - Street 1:9 SCHILLING RD
Practice Address - Street 2:SUITE 200
Practice Address - City:HUNT VALLEY
Practice Address - State:MD
Practice Address - Zip Code:21031-1191
Practice Address - Country:US
Practice Address - Phone:410-527-0280
Practice Address - Fax:410-771-9208
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD067551041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical