Provider Demographics
NPI:1417231994
Name:LARRIER, YVONNE INGRID (PHD, LPC)
Entity Type:Individual
Prefix:
First Name:YVONNE
Middle Name:INGRID
Last Name:LARRIER
Suffix:
Gender:F
Credentials:PHD, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18464 MADRID CT
Mailing Address - Street 2:
Mailing Address - City:SOUTH BEND
Mailing Address - State:IN
Mailing Address - Zip Code:46637-2354
Mailing Address - Country:US
Mailing Address - Phone:770-862-5768
Mailing Address - Fax:
Practice Address - Street 1:225 CEDAR RD
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:GA
Practice Address - Zip Code:30016-5108
Practice Address - Country:US
Practice Address - Phone:678-658-0384
Practice Address - Fax:877-266-9014
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-03
Last Update Date:2023-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC004700101YP2500X, 104100000X, 106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist