Healthcare Provider Details

I. General information

NPI: 1508539552
Provider Name (Legal Business Name): ERICA-MICHELE BURMEISTER-JACKSON LPC, NCC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/27/2021
Last Update Date: 07/17/2026
Certification Date: 07/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2545 SCHOENERSVILLE RD FL 5
BETHLEHEM PA
18017-7300
US

IV. Provider business mailing address

2100 MACK BLVD FL 4
ALLENTOWN PA
18103-5622
US

V. Phone/Fax

Practice location:
  • Phone: 484-884-6503
  • Fax: 484-884-6504
Mailing address:
  • Phone: 484-224-1183
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberPC016981
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: