Provider Demographics
NPI:1508927955
Name:JURKECH, RADKA (MED LMFT)
Entity Type:Individual
Prefix:MS
First Name:RADKA
Middle Name:
Last Name:JURKECH
Suffix:
Gender:F
Credentials:MED LMFT
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 342
Mailing Address - Street 2:
Mailing Address - City:SWARTHMORE
Mailing Address - State:PA
Mailing Address - Zip Code:19081
Mailing Address - Country:US
Mailing Address - Phone:215-618-1535
Mailing Address - Fax:
Practice Address - Street 1:280 N. PROVIDENCE RD.
Practice Address - Street 2:SUITE 106
Practice Address - City:MEDIA
Practice Address - State:PA
Practice Address - Zip Code:19063
Practice Address - Country:US
Practice Address - Phone:215-618-1535
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-12
Last Update Date:2019-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMF000406106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA493672000OtherMAGELLAN