Provider Demographics
NPI:1114343928
Name:YINGLING, JERILYN L (LPC, RPT)
Entity Type:Individual
Prefix:
First Name:JERILYN
Middle Name:L
Last Name:YINGLING
Suffix:
Gender:F
Credentials:LPC, RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 94
Mailing Address - Street 2:
Mailing Address - City:GREEN MOUNTAIN FALLS
Mailing Address - State:CO
Mailing Address - Zip Code:80819-0094
Mailing Address - Country:US
Mailing Address - Phone:719-640-5344
Mailing Address - Fax:719-686-6704
Practice Address - Street 1:400 W MIDLAND AVE STE 250D
Practice Address - Street 2:
Practice Address - City:WOODLAND PARK
Practice Address - State:CO
Practice Address - Zip Code:80863-3204
Practice Address - Country:US
Practice Address - Phone:719-686-6703
Practice Address - Fax:719-686-6704
Is Sole Proprietor?:No
Enumeration Date:2014-03-17
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPC0012668101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional