Healthcare Provider Details

I. General information

NPI: 1790852887
Provider Name (Legal Business Name): DANIEL SCOTT YEARICK LPC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/30/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

563 N MAIN ST
WAYNESVILLE NC
28786-3817
US

IV. Provider business mailing address

PO BOX 509
WAYNESVILLE NC
28786-0509
US

V. Phone/Fax

Practice location:
  • Phone: 828-456-4588
  • Fax: 828-456-4150
Mailing address:
  • Phone: 828-456-4588
  • Fax: 828-456-4150

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number2850
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: