Healthcare Provider Details

I. General information

NPI: 1083754691
Provider Name (Legal Business Name): MICHAEL ROBERT YOURON M.A.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/06/2007
Last Update Date: 06/23/2026
Certification Date: 06/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19425 LIVERPOOL PKWY STE B
CORNELIUS NC
28031-6387
US

IV. Provider business mailing address

19425 LIVERPOOL PKWY STE B
CORNELIUS NC
28031-6387
US

V. Phone/Fax

Practice location:
  • Phone: 570-498-5515
  • Fax: 704-237-4779
Mailing address:
  • Phone: 570-498-5515
  • Fax: 704-237-4779

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPS-005923-L
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number3809
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: