Provider Demographics
NPI:1487144267
Name:DUERKOP, NATALIE ROSE (MA, LPC)
Entity type:Individual
Prefix:MRS
First Name:NATALIE
Middle Name:ROSE
Last Name:DUERKOP
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:NATALIE
Other - Middle Name:ROSE
Other - Last Name:KLAHORST
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3006 BIRCH DR
Mailing Address - Street 2:
Mailing Address - City:LA CROSSE
Mailing Address - State:WI
Mailing Address - Zip Code:54601-7770
Mailing Address - Country:US
Mailing Address - Phone:262-751-9101
Mailing Address - Fax:
Practice Address - Street 1:319 MAIN ST
Practice Address - Street 2:
Practice Address - City:LA CROSSE
Practice Address - State:WI
Practice Address - Zip Code:54601-0705
Practice Address - Country:US
Practice Address - Phone:507-450-6053
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-16
Last Update Date:2018-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI6920-125101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional