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General NPI Number Information
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NPI Number | 1912070913
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Entity Type | Individual
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Provider Name | JENNIFER JEAN BURKE LMHC
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Gender | Female
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Dates
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Enumeration Date | 11/16/2006
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Last Update Date | 09/16/2020
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Provider Practice Location Address
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Address Line | 954 WHITTIER HIGHWAY
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City | MOULTONBOROUGH
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State | NH
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Zip | 03254
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Country | US
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Telephone | 603-726-6793
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1551
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City | MEREDITH
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State | NH
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Zip | 03253-1551
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Country | US
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Telephone | 603-726-6793
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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 | 824
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License Number State | NH
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