MEDICARE: YELVERTONS ENRICHMENT SERVICES INC

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
1	101Y00000X	Counselor
2	101YM0800X	Mental Health Counselor
3	101YP2500X	Professional Counselor
4	251S00000X	Community/Behavioral Health Agency	MHL040029	NC
5	251S00000X	Community/Behavioral Health Agency	MHL-040-040	NC
6	320600000X	Intellectual and/or Developmental Disabilities Residential Treatment Facility	MHL-098-137	NC
7	320800000X	Mental Illness Community Based Residential Treatment Facility	MHL040029	NC
8	322D00000X	Emotionally Disturbed Childrens' Residential Treatment Facility	MHL-040-042	NC
9	251S00000X	Community/Behavioral Health Agency

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
8	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
9	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
10	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
11	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
12	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
13	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
14	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
15	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
16	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
17	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
18	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
19	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1720136930
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	YELVERTONS ENRICHMENT SERVICES INC

Provider Business Mailing Address
First Line	:	4805 GREEN RD STE 103
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27616-2848
Country	:	US
Telephone Number	:	919-872-6220
Fax Number	:	919-872-6223

Provider Business Practice Location Address
First Line	:	4805 GREEN RD STE 103
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27616-2848
Country	:	US
Telephone Number	:	919-872-6220
Fax Number	:	919-872-6223

Authorized Official
Title or Position	:	CEO
Name	:	VICKIE SMITH YELVERTON
Credential	:	MSA
Telephone Number	:	919-872-6220

Provider Enumeration Date	:	01/07/2007
Last Update Date	:	02/03/2021

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