Healthcare Provider Details

I. General information

NPI: 1225510662
Provider Name (Legal Business Name): AMANDA YURKO LPC, NCC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/01/2018
Last Update Date: 04/13/2026
Certification Date: 04/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

871 CORONADO CENTER DR STE 200
HENDERSON NV
89052-3977
US

IV. Provider business mailing address

2533 SUNDEW AVE
HENDERSON NV
89052-2912
US

V. Phone/Fax

Practice location:
  • Phone: 908-531-5014
  • Fax:
Mailing address:
  • Phone: 908-531-5014
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number630119
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberPC010688
License Number StatePA
# 3
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberCP2778-R
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: