Provider Demographics
NPI:1497397467
Name:PICKENS, YARON (LMFT)
Entity Type:Individual
Prefix:
First Name:YARON
Middle Name:
Last Name:PICKENS
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3234 FORDHAM RD
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19114-3805
Mailing Address - Country:US
Mailing Address - Phone:215-917-3556
Mailing Address - Fax:
Practice Address - Street 1:3234 FORDHAM RD
Practice Address - Street 2:
Practice Address - City:PHILA
Practice Address - State:PA
Practice Address - Zip Code:19114-3805
Practice Address - Country:US
Practice Address - Phone:215-917-3556
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-11
Last Update Date:2021-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health