Healthcare Provider Details

I. General information

NPI: 1912945999
Provider Name (Legal Business Name): BURKE COUNSELING SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/03/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

107 BRECKENRIDGE ST
GROVE CITY PA
16127-1003
US

IV. Provider business mailing address

107 BRECKENRIDGE ST
GROVE CITY PA
16127-1003
US

V. Phone/Fax

Practice location:
  • Phone: 724-458-4330
  • Fax: 724-458-4550
Mailing address:
  • Phone: 724-458-4330
  • Fax: 724-458-4550

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: TAMIE PUGH
Title or Position: CREDENTIALING AND BILLING MANAGER
Credential:
Phone: 724-458-4330