Provider Demographics
NPI:1710660048
Name:AUTUMN COUNSELING SERVICES LLC
Entity Type:Organization
Organization Name:AUTUMN COUNSELING SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MENTAL HEALTH THERAPIST, OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HALEIGH
Authorized Official - Middle Name:
Authorized Official - Last Name:YURECKO
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:503-443-9640
Mailing Address - Street 1:8800 SE SUNNYSIDE RD STE 137S
Mailing Address - Street 2:
Mailing Address - City:CLACKAMAS
Mailing Address - State:OR
Mailing Address - Zip Code:97015-5770
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8800 SE SUNNYSIDE RD STE 137S
Practice Address - Street 2:
Practice Address - City:CLACKAMAS
Practice Address - State:OR
Practice Address - Zip Code:97015-5770
Practice Address - Country:US
Practice Address - Phone:503-443-9640
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-11
Last Update Date:2023-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty