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3413 Marla Ct Chesapeake VA 23323-1261 | |
| (757) 319-2758 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Social Worker |
| Location | 3413 Marla Ct, Chesapeake, Virginia |
| Authorized Official Name and Position | Rhonda Laruth Yancey (OUTPATIENT THERAPIST/OWNER) |
| Authorized Official Contact | 7573192758 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
3413 Marla Ct Chesapeake VA 23323-1261 Ph: (757) 319-2758 | 3413 Marla Ct Chesapeake VA 23323-1261 Ph: (757) 319-2758 |
| NPI Number | 1851155618 |
|---|---|
| Provider Enumeration Date | 02/12/2024 |
| Last Update Date | 04/16/2024 |
| Certification Date | 04/16/2024 |
| Medicare PECOS PAC ID | 6002255619 |
|---|---|
| Medicare Enrollment ID | O20240416001349 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851155618 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Rhonda L Yancey |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1760895643 PECOS PAC ID: 1759669971 Enrollment ID: I20161024000033 |
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