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NPI Code Detail

MEDICARE: MRS. LEANNE MARIE HASENFUS YATES MS, EDS, LPC

MEDICARE: MRS. LEANNE MARIE HASENFUS YATES MS, EDS, LPC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101Y00000XCounselor5161NC
2101YP2500XProfessional Counselor5161NC
3101YM0800XMental Health Counselor5161NC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1497815351
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. LEANNE MARIE HASENFUS YATES MS, EDS, LPC
Provider Business Mailing Address
First Line : 700 WALTER REED DR
Second Line :
City : GREENSBORO
State : NC
Zip : 27403-1128
Country : US
Telephone Number : 336-832-9800
Fax Number :
Provider Business Practice Location Address
First Line : 700 WALTER REED DR
Second Line :
City : GREENSBORO
State : NC
Zip : 27403-1128
Country : US
Telephone Number : 336-832-9800
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/11/2006
Last Update Date : 12/18/2009

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