Provider Demographics
NPI:1598163313
Name:YAMBAKA, STEPHANE HUGHUES (LCPC)
Entity Type:Individual
Prefix:PROF
First Name:STEPHANE
Middle Name:HUGHUES
Last Name:YAMBAKA
Suffix:
Gender:M
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:804 PERSHING DR
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20910-4434
Mailing Address - Country:US
Mailing Address - Phone:202-578-0683
Mailing Address - Fax:
Practice Address - Street 1:8609 2ND AVE STE 506B
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20910-3362
Practice Address - Country:US
Practice Address - Phone:240-398-3514
Practice Address - Fax:877-637-7490
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-10
Last Update Date:2018-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCPRC15033101YP2500X
VA0701007744101YP2500X
MDLGP5954101YP2500X
MDLC7985101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional