Provider Demographics
NPI:1598464166
Name:YEW BELONG COMMUNITY SERVICES, INC.
Entity Type:Organization
Organization Name:YEW BELONG COMMUNITY SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:WENNDY
Authorized Official - Middle Name:NICOLE
Authorized Official - Last Name:DUPKOSKI
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, LPC-S, LCMHC-S
Authorized Official - Phone:803-210-7422
Mailing Address - Street 1:105 BLACKHAWK CT
Mailing Address - Street 2:
Mailing Address - City:WEST COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29169-3712
Mailing Address - Country:US
Mailing Address - Phone:803-210-7422
Mailing Address - Fax:
Practice Address - Street 1:105 BLACKHAWK CT
Practice Address - Street 2:
Practice Address - City:WEST COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29169-3712
Practice Address - Country:US
Practice Address - Phone:803-210-7422
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-02
Last Update Date:2023-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty