MEDICARE: YAZMYNE MCDANIEL LCSWA

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		NC

General Provider Information

NPI Number	:	1881460723
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YAZMYNE MCDANIEL LCSWA

Provider Business Mailing Address
First Line	:	22 FALCONRIDGE DR
Second Line	:
City	:	SPRING LAKE
State	:	NC
Zip	:	28390-7192
Country	:	US
Telephone Number	:	336-575-2289
Fax Number	:

Provider Business Practice Location Address
First Line	:	5619 RAMSEY ST
Second Line	:
City	:	FAYETTEVILLE
State	:	NC
Zip	:	28311-1423
Country	:	US
Telephone Number	:	833-846-3463
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/01/2023
Last Update Date	:	01/22/2026

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