Healthcare Provider Details

I. General information

NPI: 1518898022
Provider Name (Legal Business Name): JONATHAN YODER PMHNP PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/26/2026
Last Update Date: 07/17/2026
Certification Date: 07/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1737 KING ST STE 330
ALEXANDRIA VA
22314-2760
US

IV. Provider business mailing address

1300 THORNTON ST STE 103
FREDERICKSBURG VA
22401-4608
US

V. Phone/Fax

Practice location:
  • Phone: 703-420-3621
  • Fax:
Mailing address:
  • Phone: 540-212-9525
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: JONATHAN YODER
Title or Position: OWNER
Credential: APRN, PMHNP-BC
Phone: 703-420-3621