Basic Information
| Provider Information | |||||||||
| NPI: | 1306085089 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | YERGES | ||||||||
| FirstName: | SENA | ||||||||
| MiddleName: | C | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | LPC, NCC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 245039 | ||||||||
| Address2: | |||||||||
| City: | MILWAUKEE | ||||||||
| State: | WI | ||||||||
| PostalCode: | 53224 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4143686070 | ||||||||
| FaxNumber: | 4143686073 | ||||||||
| Practice Location | |||||||||
| Address1: | 757 SOUTH MAIN STREET | ||||||||
| Address2: | SUITE 8 | ||||||||
| City: | FOND DU LAC | ||||||||
| State: | WI | ||||||||
| PostalCode: | 54935 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9207319798 | ||||||||
| FaxNumber: | 9207310197 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/19/2009 | ||||||||
| LastUpdateDate: | 02/24/2011 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YP2500X | 97-226 | WI | N | Behavioral Health & Social Service Providers | Counselor | Professional | 101YP2500X | 4336-125 | WI | Y | Behavioral Health & Social Service Providers | Counselor | Professional |
No ID Information.