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General NPI Number Information
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NPI Number | 1952455313
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Entity Type | Individual
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Provider Name | YANCEY JOSEPH MIRE M.S., LPC
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Gender | Male
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Dates
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Enumeration Date | 01/23/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1822 W. 2ND ST.
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City | CROWLEY
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State | LA
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Zip | 70526
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Country | US
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Telephone | 337-788-7511
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Fax |
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Provider Business Mailing Address
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Address Line | 220 DRIFTWOOD DR
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City | LAFAYETTE
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State | LA
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Zip | 70503-6020
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Country | US
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Telephone | 337-981-7219
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 2439
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License Number State | LA
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