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General NPI Number Information
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NPI Number | 1063833796
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Entity Type | Individual
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Provider Name | DIANE M BAILEY YODER LPC
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Gender | Female
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Dates
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Enumeration Date | 12/24/2013
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Last Update Date | 01/07/2026
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Provider Practice Location Address
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Address Line | 34 W GRAND AVE STE 101
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City | FOX LAKE
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State | IL
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Zip | 60020-1224
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Country | US
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Telephone | 847-322-2975
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Fax | 888-436-1636
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Provider Business Mailing Address
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Address Line | 3402 SWEETWATER LN
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City | JOHNSBURG
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State | IL
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Zip | 60051-5220
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Country | US
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Telephone | 847-322-2975
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Fax | 888-436-1636
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 10504-125
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 180.010617
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License Number State | IL
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