Provider Demographics
NPI:1841821584
Name:VERNON, YOLANDA MARIE (LCSW)
Entity type:Individual
Prefix:
First Name:YOLANDA
Middle Name:MARIE
Last Name:VERNON
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 1:211 RUTHERS RD STE 103
Mailing Address - Street 2:
Mailing Address - City:NORTH CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23235-5396
Mailing Address - Country:US
Mailing Address - Phone:804-920-5178
Mailing Address - Fax:804-276-4043
Practice Address - Street 1:211 RUTHERS RD STE 103
Practice Address - Street 2:
Practice Address - City:NORTH CHESTERFIELD
Practice Address - State:VA
Practice Address - Zip Code:23235-5396
Practice Address - Country:US
Practice Address - Phone:804-920-5178
Practice Address - Fax:804-276-4043
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-31
Last Update Date:2020-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0904011446101YS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool