=====================================================
General NPI Number Information
=====================================================
NPI Number | 1770206005
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | YOCHUM COUNSELING, A MARRIAGE AND FAMILY THERAPY PROFESSIONAL CORPORAT
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/21/2022
-----------------------------------------------------
Last Update Date | 09/21/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 9616 MICRON AVE STE 730
-----------------------------------------------------
City | SACRAMENTO
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 95827-2626
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 916-287-3602
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2686 YUMA CIR
-----------------------------------------------------
City | SACRAMENTO
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 95827-1048
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | DIRECTOR
-----------------------------------------------------
Name | LINDSEY YOCHUM
-----------------------------------------------------
Credential | LMFT
-----------------------------------------------------
Telephone | 916-287-3602
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YM0800X
-----------------------------------------------------
Taxonomy Name | Mental Health Counselor
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------