=====================================================
General NPI Number Information
=====================================================
NPI Number | 1235086596
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JUDITH N BURKHOLDER
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/14/2026
-----------------------------------------------------
Last Update Date | 03/14/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 530 W TROUT RUN RD
-----------------------------------------------------
City | EPHRATA
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 17522-9604
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 717-271-2734
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 530 W TROUT RUN RD
-----------------------------------------------------
City | EPHRATA
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 17522-9604
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 717-271-2734
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YP2500X
-----------------------------------------------------
Taxonomy Name | Professional Counselor
-----------------------------------------------------
License Number | PC020025
-----------------------------------------------------
License Number State | PA
-----------------------------------------------------