Healthcare Provider Details

I. General information

NPI: 1679399679
Provider Name (Legal Business Name): JOCELYN YEUNG LGPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/25/2024
Last Update Date: 11/25/2024
Certification Date: 11/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3417 14TH ST NW
WASHINGTON DC
20010-3402
US

IV. Provider business mailing address

1011 N GEORGE MASON DR
ARLINGTON VA
22205-2500
US

V. Phone/Fax

Practice location:
  • Phone: 240-387-9054
  • Fax:
Mailing address:
  • Phone: 917-603-3132
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLGPC200001818
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: