Provider Demographics
NPI:1821824806
Name:YBARRA, CAITLYN MONIQUE (PHD)
Entity type:Individual
Prefix:DR
First Name:CAITLYN
Middle Name:MONIQUE
Last Name:YBARRA
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6059 L P BAILEY MEMORIAL HWY
Mailing Address - Street 2:
Mailing Address - City:HALIFAX
Mailing Address - State:VA
Mailing Address - Zip Code:24558-2879
Mailing Address - Country:US
Mailing Address - Phone:434-579-7684
Mailing Address - Fax:
Practice Address - Street 1:421 HICKORY LN
Practice Address - Street 2:
Practice Address - City:PLAINFIELD
Practice Address - State:IN
Practice Address - Zip Code:46168-1836
Practice Address - Country:US
Practice Address - Phone:317-910-6047
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-09
Last Update Date:2024-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701009608101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional