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General NPI Number Information
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NPI Number | 1447485453
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Entity Type | Organization
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Legal Business Name | REBECCA C. BURCKHARDT, LPC
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Dates
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Enumeration Date | 05/19/2009
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Last Update Date | 05/19/2009
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Provider Practice Location Address
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Address Line | 255 SPENCER RD SUITE 201
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City | SAINT PETERS
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State | MO
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Zip | 63376-2494
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Country | US
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Telephone | 636-795-7815
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Fax |
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Provider Business Mailing Address
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Address Line | 255 SPENCER RD SUITE 201
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City | SAINT PETERS
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State | MO
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Zip | 63376-2494
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Country | US
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Telephone | 636-795-7815
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Fax |
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Authorized Official
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Title or Position | PROPRIETOR
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Name | MS. REBECCA CATHERINE BURCKHARDT
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Credential | LPC
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Telephone | 636-795-7815
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | MO 002706
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License Number State | MO
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