Provider Demographics
NPI:1720399876
Name:YURICK, HALLIE J (CMHC)
Entity Type:Individual
Prefix:
First Name:HALLIE
Middle Name:J
Last Name:YURICK
Suffix:
Gender:F
Credentials:CMHC
Other - Prefix:
Other - First Name:HALLIE
Other - Middle Name:J
Other - Last Name:MELLON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APC
Mailing Address - Street 1:8721 S KINGS HILL DR
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84121-6135
Mailing Address - Country:US
Mailing Address - Phone:801-502-0051
Mailing Address - Fax:
Practice Address - Street 1:8721 S KINGS HILL DR
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84121-6135
Practice Address - Country:US
Practice Address - Phone:801-502-0052
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-23
Last Update Date:2019-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT7376688-6004101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional