1720134927 NPI number — BEVERLY K. YAHNKE DBA CHRISTIAN COUNSELING SVCS

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1720134927 NPI number — BEVERLY K. YAHNKE DBA CHRISTIAN COUNSELING SVCS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BEVERLY K. YAHNKE DBA CHRISTIAN COUNSELING SVCS
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1720134927
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/15/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2600 N MAYVAIR RD, PO BOX 26097
Provider Second Line Business Mailing Address:
CHRISTIAN COUNSELING SERVICES SUITE 870
Provider Business Mailing Address City Name:
WAUWATOSA
Provider Business Mailing Address State Name:
WI
Provider Business Mailing Address Postal Code:
53226-1309
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
414-774-6770
Provider Business Mailing Address Fax Number:
414-774-3299

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2600 N MAYFAIR RD
Provider Second Line Business Practice Location Address:
SUITE 870
Provider Business Practice Location Address City Name:
WAUWATOSA
Provider Business Practice Location Address State Name:
WI
Provider Business Practice Location Address Postal Code:
53226-1309
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
414-774-6770
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/28/2007

Additional Information

Authorized Official

Authorized Official Last Name:
YAHNKE
Authorized Official First Name:
BEVERLY
Authorized Official Middle Name:
KAY
Authorized Official Title or Position:
OWNER/CLINICAL DIRECTOR
Authorized Official Telephone Number:
414-774-6770

Provider Taxonomy Codes

  • Taxonomy code: 103T00000X , with the licence number:  1395057 , registered in the state of WI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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