Healthcare Provider Details

I. General information

NPI: 1366599466
Provider Name (Legal Business Name): YVONNE ORTEGA LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/04/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1657 MERRIMAC TRL
WILLIAMSBURG VA
23185-5624
US

IV. Provider business mailing address

PO BOX 955
YORKTOWN VA
23692-0955
US

V. Phone/Fax

Practice location:
  • Phone: 757-220-3200
  • Fax: 757-253-5218
Mailing address:
  • Phone: 757-220-3200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number0701003450
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number0710101923
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: