Healthcare Provider Details

I. General information

NPI: 1841138286
Provider Name (Legal Business Name): MARION URSULA BURKE PHD, LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/24/2026
Last Update Date: 03/24/2026
Certification Date: 03/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3900 JERMANTOWN RD STE 460
FAIRFAX VA
22030-4900
US

IV. Provider business mailing address

7106 BEAR CT
SPRINGFIELD VA
22153-1301
US

V. Phone/Fax

Practice location:
  • Phone: 571-264-8192
  • Fax:
Mailing address:
  • Phone: 703-400-9551
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number0701016031
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number0811000980
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: