Healthcare Provider Details

I. General information

NPI: 1841466257
Provider Name (Legal Business Name): JAMES RICHARD YEAKEL LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/06/2008
Last Update Date: 05/06/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

275 NORTH ST
HARRISON NY
10528-1524
US

IV. Provider business mailing address

275 NORTH ST
HARRISON NY
10528-1524
US

V. Phone/Fax

Practice location:
  • Phone: 914-925-5427
  • Fax: 914-925-5169
Mailing address:
  • Phone: 914-925-5427
  • Fax: 914-925-5169

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number03862
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: