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General NPI Number Information
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NPI Number | 1487368908
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Entity Type | Organization
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Legal Business Name | BURCHBY COUNSELING INC
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Dates
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Enumeration Date | 01/09/2023
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Last Update Date | 01/09/2023
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Provider Practice Location Address
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Address Line | 40 JEWELERS PARK DR STE 100
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City | NEENAH
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State | WI
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Zip | 54956-3893
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Country | US
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Telephone | 920-245-0087
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Fax | 262-208-5321
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Provider Business Mailing Address
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Address Line | N9171 CHRISTOPHER LN
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City | APPLETON
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State | WI
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Zip | 54915-7089
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Country | US
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Telephone | 920-245-0087
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Fax |
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Authorized Official
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Title or Position | LCSW
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Name | DANEL BURCHBY
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Credential | LCSW
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Telephone | 920-245-0087
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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