Healthcare Provider Details

I. General information

NPI: 1720091879
Provider Name (Legal Business Name): EDWIN CHARLES YERKA PHD, LP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/13/2006
Last Update Date: 03/11/2026
Certification Date: 03/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

238 W MAIN ST STE 7
MARSHALL MN
56258-1398
US

IV. Provider business mailing address

506 W THOMAS AVE
MARSHALL MN
56258-2244
US

V. Phone/Fax

Practice location:
  • Phone: 507-401-2060
  • Fax: 866-260-1396
Mailing address:
  • Phone: 507-530-2837
  • Fax: 866-260-1396

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberLP4390
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: