Provider Demographics
NPI:1265310239
Name:YAKOVCHUK, KRISTIN (LPC, ACS)
Entity type:Individual
Prefix:
First Name:KRISTIN
Middle Name:
Last Name:YAKOVCHUK
Suffix:
Gender:F
Credentials:LPC, ACS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:411 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BAYVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08721-2621
Mailing Address - Country:US
Mailing Address - Phone:732-300-9713
Mailing Address - Fax:
Practice Address - Street 1:40 BEY LEA RD
Practice Address - Street 2:
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08753-2989
Practice Address - Country:US
Practice Address - Phone:732-300-9713
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-26
Last Update Date:2025-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00048000101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional