Provider Demographics
NPI:1760937676
Name:YURGEL, KELCI (MS, BCBA, LBA)
Entity Type:Individual
Prefix:
First Name:KELCI
Middle Name:
Last Name:YURGEL
Suffix:
Gender:F
Credentials:MS, BCBA, LBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2001 LAFAYETTE BLVD
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22401-2225
Mailing Address - Country:US
Mailing Address - Phone:518-744-7808
Mailing Address - Fax:
Practice Address - Street 1:219 E DAVIS ST STE 330
Practice Address - Street 2:
Practice Address - City:CULPEPER
Practice Address - State:VA
Practice Address - Zip Code:22701-3038
Practice Address - Country:US
Practice Address - Phone:540-212-9222
Practice Address - Fax:540-321-4420
Is Sole Proprietor?:No
Enumeration Date:2016-08-20
Last Update Date:2023-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001200-1103K00000X
VA0133000823103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst