Provider Demographics
NPI:1558830075
Name:LARSON, YOLANDA MARGARET (LPC)
Entity Type:Individual
Prefix:MRS
First Name:YOLANDA
Middle Name:MARGARET
Last Name:LARSON
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 1:1630 MANHEIM PIKE
Mailing Address - Street 2:SUITE 5A
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17601-6304
Mailing Address - Country:US
Mailing Address - Phone:717-475-3407
Mailing Address - Fax:
Practice Address - Street 1:1020 NEW HOLLAND AVE
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17601-5606
Practice Address - Country:US
Practice Address - Phone:717-947-1630
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-14
Last Update Date:2019-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC010811101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional