Provider Demographics
NPI:1447644562
Name:YURK COUNSELING SERVICES
Entity type:Organization
Organization Name:YURK COUNSELING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PROFESSIONAL COUNSELOR OWN
Authorized Official - Prefix:
Authorized Official - First Name:TINA
Authorized Official - Middle Name:
Authorized Official - Last Name:GRAY-SIEBERS
Authorized Official - Suffix:
Authorized Official - Credentials:LPC, CCATP
Authorized Official - Phone:920-287-0406
Mailing Address - Street 1:W4711 CASTLE DRIVE
Mailing Address - Street 2:
Mailing Address - City:SHERWOOD
Mailing Address - State:WI
Mailing Address - Zip Code:54169-9661
Mailing Address - Country:US
Mailing Address - Phone:920-287-0406
Mailing Address - Fax:920-287-0410
Practice Address - Street 1:W4711 CASTLE DRIVE
Practice Address - Street 2:
Practice Address - City:SHERWOOD
Practice Address - State:WI
Practice Address - Zip Code:54169-9661
Practice Address - Country:US
Practice Address - Phone:920-287-0406
Practice Address - Fax:920-287-0410
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-26
Last Update Date:2024-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3000-125101YM0800X
101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty