James K Dercks, LPC
Counselor, Professional in Menasha, WI. Individual provider (NPI-1).
NPI number1134586779
StatusActive
Last updated in NPPESDec 12, 2017
Details
- NPI
- 1134586779
- Entity type
- Individual (NPI-1)
- Name
- James K Dercks
- Credential
- LPC
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jan 27, 2016
- Last updated
- Dec 12, 2017
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YP2500X | Counselor, Professional | 6749 | WI | Yes |
Practice location
1810 Appleton RdMenasha, WI 54952-1110
Phone 920-739-4226 · Fax 920-739-7639
Mailing address
1810 Appleton RdMenasha, WI 54952-1110
Phone 920-739-4226 · Fax 920-739-7639
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