Provider Demographics
NPI:1609248970
Name:YODER, ROGER (LMHC)
Entity Type:Individual
Prefix:
First Name:ROGER
Middle Name:
Last Name:YODER
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3028 W 21ST AVE
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99224
Mailing Address - Country:US
Mailing Address - Phone:316-993-1172
Mailing Address - Fax:
Practice Address - Street 1:3157 E. 17TH AVE
Practice Address - Street 2:GREENLEAF PSYCHOLOGY & COUNSELING
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99223
Practice Address - Country:US
Practice Address - Phone:509-838-8066
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-10-27
Last Update Date:2015-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor