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NPI Code Detail

MEDICARE: MS. ELLEN M YASS-REED M.A.

MEDICARE:  MS. ELLEN M YASS-REED  M.A.
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
1101YA0400XAddiction (Substance Use Disorder) Counselor114305KY
2103T00000XPsychologist114305KY
3103TC2200XClinical Child & Adolescent Psychologist114305KY
4103TC0700XClinical Psychologist114305KY

General Provider Information

NPI Number : 1831253400
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. ELLEN M YASS-REED M.A.
Provider Business Mailing Address
First Line : 2128 CHAMBER CENTER DR
Second Line :
City : LAKESIDE PARK
State : KY
Zip : 41017-1669
Country : US
Telephone Number : 859-331-6525
Fax Number : 859-331-6526
Provider Business Practice Location Address
First Line : 2128 CHAMBER CENTER DR
Second Line :
City : FORT MITCHELL
State : KY
Zip : 41017-1669
Country : US
Telephone Number : 859-331-6525
Fax Number : 859-331-6526
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/20/2006
Last Update Date : 04/13/2020

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