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General NPI Number Information
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NPI Number | 1609313790
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Entity Type | Individual
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Provider Name | ALYSSA MICHELLE BURTNER PSYD, LCP
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Gender | Female
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Dates
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Enumeration Date | 01/26/2017
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Last Update Date | 09/30/2024
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Provider Practice Location Address
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Address Line | 2500 W HIGGINS RD STE 1250
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City | HOFFMAN ESTATES
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State | IL
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Zip | 60169-2051
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Country | US
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Telephone | 847-303-1880
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Fax |
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Provider Business Mailing Address
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Address Line | 2500 W HIGGINS RD STE 1250
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City | HOFFMAN ESTATES
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State | IL
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Zip | 60169-2051
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Country | US
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Telephone |
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 178011734
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 071010012
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License Number State | IL
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