Provider Demographics
NPI:1265123129
Name:GALES, YOLANDA (LGPC)
Entity type:Individual
Prefix:
First Name:YOLANDA
Middle Name:
Last Name:GALES
Suffix:
Gender:F
Credentials:LGPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1802 BRIGHTSEAT RD STE 300
Mailing Address - Street 2:
Mailing Address - City:HYATTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20785-4244
Mailing Address - Country:US
Mailing Address - Phone:240-249-0989
Mailing Address - Fax:
Practice Address - Street 1:1802 BRIGHTSEAT RD STE 300
Practice Address - Street 2:
Practice Address - City:HYATTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20785-4244
Practice Address - Country:US
Practice Address - Phone:240-249-0989
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-19
Last Update Date:2023-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLGP11842101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health