Mark Yancey Sr., CADCII

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

AII15590316 Issued in CA

Practice address

1133 Coloma Way Ste C
Roseville, CA 95661-4480

Phone

(916) 774-6647

NPI assigned

Jan 30, 2017

Last updated

Feb 14, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Electronic endpoints 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Yancey Outreach International Inc.

  dba Yancey Christian Recovery Services

  • Addiction (Substance Use Disorder) Counselor
  • Sacramento, CA
  • NPI 1033739321
  NPD Authorized official
• Yancey Outreach International Inc.

  dba Yancey Recovery Services

  • Community Health Worker
  • Sacramento, CA
  • NPI 1922865500
  NPD Authorized official
• God's Word Bible Church

  • PACE Provider Organization
  • Sacramento, CA
  • NPI 1386181329
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1485734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644796800000",
    "number": "1386181337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2701 DEL PASO RD # 130-250",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958352305",
            "telephone_number": "916-914-5012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1133 COLOMA WAY STE C",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956614480",
            "telephone_number": "916-774-6647"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YANCEY",
        "first_name": "MARK",
        "name_suffix": "Sr.",
        "credential": "CADCII",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-01-30",
        "last_updated": "2022-02-14",
        "certification_date": "2021-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "AII15590316",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mark.yancey@pinnacletreatment.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1133 Coloma Way Ste C",
            "city": "Roseville",
            "state": "CA",
            "country_code": "US",
            "postal_code": "956614480",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mark.yancey@pinnacletreatment.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1133 Coloma Way Ste C",
            "city": "Roseville",
            "state": "CA",
            "country_code": "US",
            "postal_code": "956614480",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Dorothy Deguzman Yancik
• Chou Yang, R.N.
• Chunlin Yang, M.D.
• Edna Yang

• Addiction (Substance Use Disorder) Counselor in Roseville, CA
• Providers in Roseville, CA by specialty
• Addiction (Substance Use Disorder) Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.