Provider Demographics
NPI:1891075974
Name:SKLAD, YURI M (LMFT)
Entity type:Individual
Prefix:
First Name:YURI
Middle Name:M
Last Name:SKLAD
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:YURIY
Other - Middle Name:
Other - Last Name:SKLADANOVSKIY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:820 S WASHINGTON ST APT A228
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22314-4285
Mailing Address - Country:US
Mailing Address - Phone:952-484-3299
Mailing Address - Fax:
Practice Address - Street 1:820 S WASHINGTON ST APT A228
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22314-4285
Practice Address - Country:US
Practice Address - Phone:952-484-3299
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-22
Last Update Date:2015-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health