Provider Demographics
NPI:1568560548
Name:YURK, WENDY J (MS LPC)
Entity Type:Individual
Prefix:
First Name:WENDY
Middle Name:J
Last Name:YURK
Suffix:
Gender:F
Credentials:MS LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:615 SOUTH 8TH ST
Mailing Address - Street 2:STE G 20
Mailing Address - City:SHEBOYGAN
Mailing Address - State:WI
Mailing Address - Zip Code:53081
Mailing Address - Country:US
Mailing Address - Phone:920-457-8866
Mailing Address - Fax:920-457-8867
Practice Address - Street 1:615 SOUTH 8TH ST
Practice Address - Street 2:STE G 20
Practice Address - City:SHEBOYGAN
Practice Address - State:WI
Practice Address - Zip Code:53081
Practice Address - Country:US
Practice Address - Phone:920-457-8866
Practice Address - Fax:920-457-8867
Is Sole Proprietor?:No
Enumeration Date:2006-09-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3000125101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional