Individual
MRS. CHERYL LEE YAKAVONIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NCC, LPC
Contact information
Practice address
115 LEARN RD FL 2, TANNERSVILLE, PA 18372-7951
(570) 213-2817
(855) 244-2286
Mailing address
PO BOX 261, TANNERSVILLE, PA 18372-0261
(570) 213-2817
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
PC004848
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1033764220001
PROMISE PROVIDER ID (CHIP ONLY)
PA
05
—
1033764220001
—
PA
Enumeration date
05/14/2008
Last updated
05/30/2019
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