Provider Demographics
NPI:1689950123
Name:PINA, YERKY URKANIA (MED)
Entity Type:Individual
Prefix:
First Name:YERKY
Middle Name:URKANIA
Last Name:PINA
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:YERKY
Other - Middle Name:URKANIA
Other - Last Name:CRUZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:875 STATE RD UNIT 11 SUITE 152
Mailing Address - Street 2:
Mailing Address - City:WESTPORT
Mailing Address - State:MA
Mailing Address - Zip Code:02790-7482
Mailing Address - Country:US
Mailing Address - Phone:508-916-2081
Mailing Address - Fax:508-742-9959
Practice Address - Street 1:450 PEARL ST
Practice Address - Street 2:
Practice Address - City:STOUGHTON
Practice Address - State:MA
Practice Address - Zip Code:02072-1610
Practice Address - Country:US
Practice Address - Phone:781-344-0057
Practice Address - Fax:781-344-0027
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-28
Last Update Date:2021-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA12428101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health