Provider Demographics
NPI:1750314118
Name:YEREX, DINA LYNN (LPC, CADCIII, CGACII)
Entity Type:Individual
Prefix:
First Name:DINA
Middle Name:LYNN
Last Name:YEREX
Suffix:
Gender:F
Credentials:LPC, CADCIII, CGACII
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39332 PROCTOR BLVD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:SANDY
Mailing Address - State:OR
Mailing Address - Zip Code:97055-8079
Mailing Address - Country:US
Mailing Address - Phone:971-226-4040
Mailing Address - Fax:
Practice Address - Street 1:39332 PROCTOR BLVD
Practice Address - Street 2:SUITE 103
Practice Address - City:SANDY
Practice Address - State:OR
Practice Address - Zip Code:97055-8079
Practice Address - Country:US
Practice Address - Phone:971-226-4040
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-09
Last Update Date:2013-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC #79939101Y00000X
ORCGAC II #G 07-07-08101Y00000X
ORC2100101YP2500X
ORCADC III (#07-12-64)101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)