Active NPI
Joseph Yazvac III, PH.D.
- Counseling Psychologist
- Keene, NH
National Provider Identifier
1215265830
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counseling Psychologist
- License
- 1258
- Practice address
- 151 West St
2ND Floor
Keene, NH 03431-3359 - Phone
- (812) 605-0169
- NPI assigned
- Nov 19, 2009
- Last updated
- Sep 13, 2015
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counseling Psychologist | 103TC1900X | 1258 | NH | Primary |
Addresses
Primary practice location
151 West St
2ND Floor
Keene, NH 03431-3359
Mailing address
151 West St
2ND Floor
Keene, NH 03431-3359
Phone (812) 605-0169
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1258 | NH | MD | Counseling Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1258588800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1442102400000",
"number": "1215265830",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "151 WEST ST",
"address_2": "2ND FLOOR",
"city": "KEENE",
"state": "NH",
"postal_code": "034313359",
"telephone_number": "812-605-0169"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "151 WEST ST",
"address_2": "2ND FLOOR",
"city": "KEENE",
"state": "NH",
"postal_code": "034313359",
"telephone_number": "812-605-0169"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YAZVAC",
"first_name": "JOSEPH",
"name_prefix": "Dr.",
"name_suffix": "III",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-11-19",
"last_updated": "2015-09-13",
"status": "A"
},
"taxonomies": [
{
"code": "103TC1900X",
"taxonomy_group": "",
"desc": "Psychologist, Counseling",
"state": "NH",
"license": "1258",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Keene, NH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.