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General NPI Number Information
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NPI Number | 1679313910
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Entity Type | Individual
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Provider Name | STACY LYNN YEAGER LMSW
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Gender | Female
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Dates
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Enumeration Date | 05/24/2024
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Last Update Date | 01/22/2026
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Provider Practice Location Address
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Address Line | 601 E SELTICE WAY STE 103
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City | POST FALLS
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State | ID
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Zip | 83854-5336
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Country | US
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Telephone | 208-660-5382
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Fax |
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Provider Business Mailing Address
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Address Line | 5796 N MORLEAU LN
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City | COEUR D ALENE
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State | ID
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Zip | 83815-0424
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Country | US
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Telephone | 208-660-5382
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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 | 45187
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License Number State | ID
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