Individual
JAMES K DERCKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
1810 APPLETON RD, MENASHA, WI 54952-1110
(920) 739-4226
(920) 739-7639
Mailing address
1810 APPLETON RD, MENASHA, WI 54952-1110
(920) 739-4226
(920) 739-7639
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
6749
WI
Other
Enumeration date
01/27/2016
Last updated
12/12/2017
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