MEDICARE: KAYLIE TEREASE YSASI M.S.

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	101YM0800X	Mental Health Counselor	A21564	NC

General Provider Information

NPI Number	:	1902797707
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAYLIE TEREASE YSASI M.S.

Provider Business Mailing Address
First Line	:	209 SPRINGLEAF CT
Second Line	:
City	:	HOLLY SPRINGS
State	:	NC
Zip	:	27540-8624
Country	:	US
Telephone Number	:	252-702-0074
Fax Number	:

Provider Business Practice Location Address
First Line	:	209 SPRINGLEAF CT
Second Line	:
City	:	HOLLY SPRINGS
State	:	NC
Zip	:	27540-8624
Country	:	US
Telephone Number	:	252-702-0074
Fax Number	:

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

Provider Enumeration Date	:	07/10/2025
Last Update Date	:	12/02/2025

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