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General NPI Number Information
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NPI Number | 1457049611
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Entity Type | Individual
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Provider Name | HOLLY E YATES MSW, LGSW
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Gender | Female
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Dates
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Enumeration Date | 04/26/2023
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Last Update Date | 02/03/2026
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Provider Practice Location Address
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Address Line | 101 MEDICAL CT STE 108
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City | MARTINSBURG
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State | WV
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Zip | 25401-3854
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Country | US
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Telephone | 304-268-5330
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Fax |
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Provider Business Mailing Address
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Address Line | 174 COOLIDGE DR
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City | INWOOD
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State | WV
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Zip | 25428-3768
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Country | US
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Telephone | 304-671-8006
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Fax |
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | BP00945554
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License Number State | WV
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