MEDICARE: TIFFANY NOELLE BURKE LCPC, LPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1386981934
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TIFFANY NOELLE BURKE LCPC, LPC

Provider Business Mailing Address
First Line	:	12 WOLF CREEK DR STE 100
Second Line	:
City	:	SWANSEA
State	:	IL
Zip	:	62226-2314
Country	:	US
Telephone Number	:	618-600-4502
Fax Number	:

Provider Business Practice Location Address
First Line	:	1423 ROGER AVE
Second Line	:
City	:	SWANSEA
State	:	IL
Zip	:	62226-2101
Country	:	US
Telephone Number	:	618-600-4502
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/15/2013
Last Update Date	:	02/12/2026

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