Provider Demographics
NPI:1558569467
Name:URKE, EMILY BEHREND (PSYD)
Entity Type:Individual
Prefix:DR
First Name:EMILY
Middle Name:BEHREND
Last Name:URKE
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:308 12TH AVE S
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:MN
Mailing Address - Zip Code:55313-2321
Mailing Address - Country:US
Mailing Address - Phone:763-682-4400
Mailing Address - Fax:
Practice Address - Street 1:308 12TH AVE S
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:MN
Practice Address - Zip Code:55313-2321
Practice Address - Country:US
Practice Address - Phone:763-682-4400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-03
Last Update Date:2010-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN1558569467OtherTRICARE/TRIWEST
MN1558569467OtherBLUE CROSS BLUE SHIELD
MN1558569467Medicaid
MN1558569467OtherHEALTH PARTNERS
MN1558569467OtherMMSI
MN1558569467OtherSAND CREEK