Healthcare Provider Details

I. General information

NPI: 1356838395
Provider Name (Legal Business Name): KIRSTEN BURKS BA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/16/2018
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105 FLORAL VALE BLVD
YARDLEY PA
19067-5522
US

IV. Provider business mailing address

105 FLORAL VALE BLVD
YARDLEY PA
19067-5522
US

V. Phone/Fax

Practice location:
  • Phone: 856-412-8777
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: