Active NPI
Tiffany Lee Yates, LMFT
- Counselor
- South Bend, IN
National Provider Identifier
1922564087
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- 35002040A
- Practice address
- 430 E Lasalle Ave
South Bend, IN 46617-2724 - Phone
- (574) 229-2404
- NPI assigned
- Feb 13, 2019
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Counselor | 101Y00000X | 35002040A | IN | Primary |
Addresses
Primary practice location
430 E Lasalle Ave
South Bend, IN 46617-2724
Mailing address
601 Smith St
Mishawaka, IN 46544-4864
Phone (574) 229-2404
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35002040A | IN | MD | Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1550016000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1550016000000",
"number": "1922564087",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "601 SMITH ST",
"city": "MISHAWAKA",
"state": "IN",
"postal_code": "465444864",
"telephone_number": "574-229-2404"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "430 E LASALLE AVE",
"city": "SOUTH BEND",
"state": "IN",
"postal_code": "466172724",
"telephone_number": "574-229-2404"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YATES",
"first_name": "TIFFANY",
"middle_name": "LEE",
"name_prefix": "Mrs.",
"credential": "LMFT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-02-13",
"last_updated": "2019-02-13",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "IN",
"license": "35002040A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in South Bend, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.