Provider Demographics
NPI:1003335613
Name:YOCHUM, AMANDA S (LPC)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:S
Last Name:YOCHUM
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 MUNICIPAL DR
Mailing Address - Street 2:
Mailing Address - City:ARNOLD
Mailing Address - State:MO
Mailing Address - Zip Code:63010-1012
Mailing Address - Country:US
Mailing Address - Phone:636-296-6206
Mailing Address - Fax:636-296-0102
Practice Address - Street 1:110 N MILL ST
Practice Address - Street 2:
Practice Address - City:FESTUS
Practice Address - State:MO
Practice Address - Zip Code:63028-1816
Practice Address - Country:US
Practice Address - Phone:636-931-2700
Practice Address - Fax:636-931-1961
Is Sole Proprietor?:No
Enumeration Date:2017-09-14
Last Update Date:2023-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2015040214101YA0400X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)