Provider Demographics
NPI:1891801387
Name:YARBROUGH, RICHARD (LPCC)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:
Last Name:YARBROUGH
Suffix:
Gender:M
Credentials:LPCC
Other - Prefix:
Other - First Name:RICHARD
Other - Middle Name:P
Other - Last Name:YARBROUGH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LPCC
Mailing Address - Street 1:513 WINDSOR PARK DR
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45459-4112
Mailing Address - Country:US
Mailing Address - Phone:937-620-7646
Mailing Address - Fax:
Practice Address - Street 1:513 WINDSOR PARK DR
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45459-4112
Practice Address - Country:US
Practice Address - Phone:937-620-7646
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-21
Last Update Date:2019-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X
OHE1402101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty