Provider Demographics
NPI:1558867622
Name:YARNELL, JODI BETH (EDS, PSYD)
Entity Type:Individual
Prefix:MS
First Name:JODI
Middle Name:BETH
Last Name:YARNELL
Suffix:
Gender:F
Credentials:EDS, PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:920 A ST
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23451-5518
Mailing Address - Country:US
Mailing Address - Phone:610-306-2684
Mailing Address - Fax:
Practice Address - Street 1:641 CARRIAGE HILL RD
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23452-6518
Practice Address - Country:US
Practice Address - Phone:757-263-2700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-05
Last Update Date:2020-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0813000898103TS0200X
VA0810006147103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool