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General NPI Number Information
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NPI Number | 1932830478
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Entity Type | Individual
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Provider Name | KENNETH GREGORY BURKE LPC
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Gender | Male
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Dates
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Enumeration Date | 06/23/2022
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Last Update Date | 12/17/2024
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Provider Practice Location Address
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Address Line | 9229 WARD PKWY STE 260
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City | KANSAS CITY
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State | MO
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Zip | 64114-3333
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Country | US
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Telephone | 816-289-2687
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Fax | 913-273-1561
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Provider Business Mailing Address
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Address Line | 4419 W 112TH TER
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City | LEAWOOD
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State | KS
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Zip | 66211-1718
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Country | US
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Telephone | 816-289-2687
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Fax | 913-273-1561
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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 | 2022020355
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License Number State | MO
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