Provider Demographics
NPI:1336214360
Name:YASEMSKY, DAVID (LPC)
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:
Last Name:YASEMSKY
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2117 SMITH AVE STE B
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23320-2519
Mailing Address - Country:US
Mailing Address - Phone:757-547-9007
Mailing Address - Fax:757-786-2805
Practice Address - Street 1:2117 SMITH AVE STE B
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23320-2519
Practice Address - Country:US
Practice Address - Phone:757-547-9007
Practice Address - Fax:757-786-2805
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-22
Last Update Date:2024-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701002229101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010063434Medicaid
VA30016652470005Medicaid