MEDICARE: MRS. SHAWNNA BURKE LMFT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	LF00001929	WA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1902959067
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. SHAWNNA BURKE LMFT

Provider Business Mailing Address
First Line	:	1950 KEENE RD
Second Line	:	BLDG H
City	:	RICHLAND
State	:	WA
Zip	:	99352-7751
Country	:	US
Telephone Number	:	509-528-8538
Fax Number	:	509-735-4971

Provider Business Practice Location Address
First Line	:	1950 KEENE RD
Second Line	:	BLDG H
City	:	RICHLAND
State	:	WA
Zip	:	99352-7751
Country	:	US
Telephone Number	:	509-528-8538
Fax Number	:	509-735-4971

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/19/2007
Last Update Date	:	01/15/2013

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