Provider Demographics
NPI:1720383037
Name:GANDY, YVONNE H (LCSW, LCDC)
Entity type:Individual
Prefix:MRS
First Name:YVONNE
Middle Name:H
Last Name:GANDY
Suffix:
Gender:F
Credentials:LCSW, LCDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3524 KNICKERBOCKER RD STE C-266
Mailing Address - Street 2:
Mailing Address - City:SAN ANGELO
Mailing Address - State:TX
Mailing Address - Zip Code:76904-7632
Mailing Address - Country:US
Mailing Address - Phone:325-253-5828
Mailing Address - Fax:
Practice Address - Street 1:3524 KNICKERBOCKER RD STE C-266
Practice Address - Street 2:
Practice Address - City:SAN ANGELO
Practice Address - State:TX
Practice Address - Zip Code:76904-7632
Practice Address - Country:US
Practice Address - Phone:325-253-5828
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-18
Last Update Date:2025-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMCBT-2023-0661101YA0400X
TX696331041C0700X
TX15406101YA0400X
SC832101YA0400X
NE1509101YA0400X
AZLIAC-155358101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)