Healthcare Provider Details

I. General information

NPI: 1316664311
Provider Name (Legal Business Name): EMILY BURDETTE M.S., LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/20/2022
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 COOPER POINT RD SW STE 22511063
OLYMPIA WA
98502-8705
US

IV. Provider business mailing address

400 COOPER POINT RD SW STE 22511063
OLYMPIA WA
98502-8705
US

V. Phone/Fax

Practice location:
  • Phone: 504-358-8690
  • Fax:
Mailing address:
  • Phone: 504-358-8690
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLF61687536
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: