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General NPI Number Information
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NPI Number | 1588370811
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Entity Type | Individual
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Provider Name | NICOLE BURDEN LPC
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Gender | Female
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Dates
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Enumeration Date | 01/30/2023
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Last Update Date | 09/25/2024
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Provider Practice Location Address
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Address Line | 217 WISCONSIN AVE STE 211
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City | WAUKESHA
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State | WI
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Zip | 53186-4946
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Country | US
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Telephone | 414-877-4570
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Fax | 142-819-8844
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Provider Business Mailing Address
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Address Line | 8045 S MONA DR
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City | OAK CREEK
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State | WI
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Zip | 53154-3033
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Country | US
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Telephone | 414-840-1583
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 7217
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 11264
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License Number State | WI
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