Healthcare Provider Details

I. General information

NPI: 1073506564
Provider Name (Legal Business Name): JEANNE B BURGER EDD LPC LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 08/30/2005
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

ACADEMY CROSSING MEDICAL PLAZA 3300 ACADEMY AVE
PORTSMOUTH VA
23703-3205
US

IV. Provider business mailing address

ACADEMY CROSSING MEDICAL PLAZA 3300 ACADEMY AVENUE
PORTSMOUTH VA
23703-3205
US

V. Phone/Fax

Practice location:
  • Phone: 757-483-6404
  • Fax: 757-483-0737
Mailing address:
  • Phone: 757-483-6404
  • Fax: 757-483-0737

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number0701001522
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number0717000013
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: