Individual
DR. JEROME YELDER SR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD PSYD MBA MS MP
Contact information
Practice address
1101 BELLEVIEW ST STE 104, COLUMBIA, SC 29201-1863
(803) 937-1623
(803) 937-1623
Mailing address
1101 BELLEVIEW ST STE 104, COLUMBIA, SC 29201-1863
(803) 937-1623
(803) 937-1623
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
45428
SC
101YP1600X
Pastoral Counselor
61388
SC
103G00000X
Clinical Neuropsychologist
573768
SC
103TP0016X
Prescribing (Medical) Psychologist
Primary
159AMP
SC
171000000X
Military Health Care Provider
159AMP
SC
171W00000X
Contractor
73276
SC
174H00000X
Health Educator
73276
SC
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
5768
SC
208VP0014X
Interventional Pain Medicine Physician
159AMP
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
273614612
—
SC
05
—
GP7839
—
SC
Enumeration date
04/28/2011
Last updated
07/08/2020
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