Provider Demographics
NPI:1437169349
Name:YEAGER, MICHAEL THADDEUS (LCDC, CAS)
Entity type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:THADDEUS
Last Name:YEAGER
Suffix:
Gender:M
Credentials:LCDC, CAS
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Mailing Address - Street 1:9525 KATY FREEWAY
Mailing Address - Street 2:SUITE 428
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77024
Mailing Address - Country:US
Mailing Address - Phone:713-461-3279
Mailing Address - Fax:713-461-9329
Practice Address - Street 1:9525 KATY FREEWAY
Practice Address - Street 2:SUITE 428
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77024
Practice Address - Country:US
Practice Address - Phone:713-461-3279
Practice Address - Fax:713-461-9329
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-09
Last Update Date:2021-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX371101YA0400X
TXAD00126171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No171100000XOther Service ProvidersAcupuncturist