Provider Demographics
NPI:1104008077
Name:YARBROUGH, TANIKA (LCSW)
Entity type:Individual
Prefix:
First Name:TANIKA
Middle Name:
Last Name:YARBROUGH
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 1:5404 EDGEFIELD ST
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23227-2619
Mailing Address - Country:US
Mailing Address - Phone:804-261-5715
Mailing Address - Fax:
Practice Address - Street 1:300 ARBORETUM PL STE 502
Practice Address - Street 2:
Practice Address - City:NORTH CHESTERFIELD
Practice Address - State:VA
Practice Address - Zip Code:23236-3473
Practice Address - Country:US
Practice Address - Phone:804-560-8001
Practice Address - Fax:804-560-6875
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-03
Last Update Date:2019-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040062541041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical