Provider Demographics
NPI:1588438154
Name:YVONNE M. FALL, LPC, LLC
Entity type:Organization
Organization Name:YVONNE M. FALL, LPC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PSYCHOTHERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:YVONNE
Authorized Official - Middle Name:M
Authorized Official - Last Name:FALL
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:804-412-8515
Mailing Address - Street 1:9568 KINGS CHARTER DR STE 103
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:VA
Mailing Address - Zip Code:23005-7955
Mailing Address - Country:US
Mailing Address - Phone:804-412-8515
Mailing Address - Fax:844-809-7256
Practice Address - Street 1:9568 KINGS CHARTER DR STE 103
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:VA
Practice Address - Zip Code:23005-7955
Practice Address - Country:US
Practice Address - Phone:804-412-8515
Practice Address - Fax:844-809-7256
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-14
Last Update Date:2023-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty