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NPI Code Detail

MEDICARE: ASHLEY J BURKETT PLPC

MEDICARE: ASHLEY J BURKETT PLPC
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
1101YS0200XSchool Counselor
2101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1912753997
Entity Type Code : Individual
Provider Name (Legal Business Name) : ASHLEY J BURKETT PLPC
Provider Business Mailing Address
First Line : 523 SAPPHIRE DR
Second Line :
City : O FALLON
State : MO
Zip : 63366-1889
Country : US
Telephone Number : 314-368-2409
Fax Number : 314-442-4139
Provider Business Practice Location Address
First Line : 12 FEE FEE RD
Second Line :
City : MARYLAND HEIGHTS
State : MO
Zip : 63043-2729
Country : US
Telephone Number : 314-368-2409
Fax Number : 314-442-4139
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/29/2024
Last Update Date : 04/29/2024

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