Healthcare Provider Details

I. General information

NPI: 1568814507
Provider Name (Legal Business Name): JULIA YEARWOOD PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/01/2016
Last Update Date: 07/21/2025
Certification Date: 07/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3506 W TYVOLA RD
CHARLOTTE NC
28208-7201
US

IV. Provider business mailing address

3506 W TYVOLA RD
CHARLOTTE NC
28208-7201
US

V. Phone/Fax

Practice location:
  • Phone: 704-329-1300
  • Fax:
Mailing address:
  • Phone: 703-329-1300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number5068
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: