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General NPI Number Information
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NPI Number | 1013534924
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Entity Type | Individual
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Provider Name | AMBER BURCHETT LPC
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Gender | Female
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Dates
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Enumeration Date | 06/26/2020
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Last Update Date | 06/26/2020
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Provider Practice Location Address
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Address Line | 1500 EISENHOWER LN STE 900
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City | LISLE
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State | IL
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Zip | 60532-2135
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Country | US
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Telephone | 630-428-7890
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Fax |
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Provider Business Mailing Address
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Address Line | 11234 S LECLAIRE AVE
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City | ALSIP
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State | IL
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Zip | 60803-6067
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Country | US
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Telephone | 773-358-0527
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 178.015159
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License Number State | IL
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