Healthcare Provider Details

I. General information

NPI: 1770697641
Provider Name (Legal Business Name): NANCY W. YEATES LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/18/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6901 S PIERCE ST STE 380
LITTLETON CO
80128-4554
US

IV. Provider business mailing address

6901 S PIERCE ST STE 380
LITTLETON CO
80128-4554
US

V. Phone/Fax

Practice location:
  • Phone: 303-312-1510
  • Fax: 303-904-2374
Mailing address:
  • Phone: 303-312-1510
  • Fax: 303-904-2374

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number996684
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: