Individual
BETH YOUNG-VERKUILEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S.
Contact information
Practice address
806 VALLEY RD STE 21, MENASHA, WI 54952-1012
(920) 882-9877
(920) 882-9880
Mailing address
W7175 FIRELANE 2, MENASHA, WI 54952-9401
(920) 740-1065
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
3904
WI
106H00000X
Marriage & Family Therapist
149
WI
106H00000X
Marriage & Family Therapist
149-123
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
39-1917728
TAXPAYOR ID
WI
Enumeration date
04/10/2007
Last updated
05/07/2024
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