Cheryl Lee Yakavonis, NCC, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

PC004848 Issued in PA

Practice address

115 Learn Rd FL 2
Tannersville, PA 18372-7951

Phone

(570) 213-2817

Fax

(855) 244-2286

NPI assigned

May 14, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1210723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559174400000",
    "number": "1598932857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 261",
            "city": "TANNERSVILLE",
            "state": "PA",
            "postal_code": "183720261",
            "telephone_number": "570-213-2817"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 LEARN RD FL 2",
            "city": "TANNERSVILLE",
            "state": "PA",
            "postal_code": "183727951",
            "telephone_number": "570-213-2817",
            "fax_number": "855-244-2286"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "115 Learn Rd",
            "address_purpose": "LOCATION",
            "city": "Tannersville",
            "state": "PA",
            "postal_code": "183727951",
            "country_code": "US",
            "telephone_number": "570-213-2817",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YAKAVONIS",
        "first_name": "CHERYL",
        "middle_name": "LEE",
        "name_prefix": "Mrs.",
        "credential": "NCC, LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-05-14",
        "last_updated": "2019-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "PA",
            "license": "PC004848",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROMISE PROVIDER ID (CHIP ONLY)",
            "identifier": "1033764220001",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1033764220001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bethel Elaine Sucro, LPC
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• Jeffrey Robert Wert, D.M.D.

• Professional Counselor in Tannersville, PA
• Providers in Tannersville, PA by specialty
• Professional Counselor in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2019; 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.