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General NPI Number Information
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NPI Number | 1629733936
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Entity Type | Organization
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Legal Business Name | TERA BUERKLE LLC
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Dates
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Enumeration Date | 11/02/2021
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Last Update Date | 06/20/2025
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Provider Practice Location Address
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Address Line | 1711 BARDSTOWN RD STE 201
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City | LOUISVILLE
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State | KY
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Zip | 40205-2258
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Country | US
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Telephone | 859-359-8266
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Fax |
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Provider Business Mailing Address
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Address Line | 1711 BARDSTOWN RD STE 201
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City | LOUISVILLE
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State | KY
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Zip | 40205-2258
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Country | US
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Telephone | 859-359-8266
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Fax |
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Authorized Official
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Title or Position | LICENSED MARRIAGE & FAMILY THERAPY
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Name | TERA M BUERKLE
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Credential | M.S.
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Telephone | 859-359-8266
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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