Provider Demographics
NPI:1760895643
Name:YANCEY, RHONDA LARUTH (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:RHONDA
Middle Name:LARUTH
Last Name:YANCEY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3255 GALBERRY RD
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23323-1302
Mailing Address - Country:US
Mailing Address - Phone:757-319-2758
Mailing Address - Fax:
Practice Address - Street 1:129 N SARATOGA ST STE 1
Practice Address - Street 2:
Practice Address - City:SUFFOLK
Practice Address - State:VA
Practice Address - Zip Code:23434-5255
Practice Address - Country:US
Practice Address - Phone:757-539-5353
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-09
Last Update Date:2014-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040086221041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical