Provider Demographics
NPI:1235702366
Name:TSARENKO-CAREY, YULIA V (PCA)
Entity type:Individual
Prefix:
First Name:YULIA
Middle Name:V
Last Name:TSARENKO-CAREY
Suffix:
Gender:F
Credentials:PCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3100 EDGEMONT RD
Mailing Address - Street 2:
Mailing Address - City:LAKE OSWEGO
Mailing Address - State:OR
Mailing Address - Zip Code:97035-3568
Mailing Address - Country:US
Mailing Address - Phone:845-475-4918
Mailing Address - Fax:
Practice Address - Street 1:3100 EDGEMONT RD
Practice Address - Street 2:
Practice Address - City:LAKE OSWEGO
Practice Address - State:OR
Practice Address - Zip Code:97035-3568
Practice Address - Country:US
Practice Address - Phone:845-475-4918
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-16
Last Update Date:2024-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YP2500X, 101YM0800X
ORR7696101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional