Provider Demographics
NPI:1629721774
Name:GREEN, YOSHIKO (LPC)
Entity Type:Individual
Prefix:
First Name:YOSHIKO
Middle Name:
Last Name:GREEN
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 1:4808 HILLBROOK AVE
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23231-2147
Mailing Address - Country:US
Mailing Address - Phone:804-691-1949
Mailing Address - Fax:804-222-8565
Practice Address - Street 1:1 W WILLIAMSBURG RD
Practice Address - Street 2:
Practice Address - City:SANDSTON
Practice Address - State:VA
Practice Address - Zip Code:23150-2009
Practice Address - Country:US
Practice Address - Phone:804-691-1949
Practice Address - Fax:804-326-1316
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-29
Last Update Date:2022-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA07011011156101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health