MEDICARE: KATHERINE BURLESON 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	0701014496	VA

General Provider Information

NPI Number	:	1427862242
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHERINE BURLESON LPC

Provider Business Mailing Address
First Line	:	1604 HILLTOP WEST SHOPPING CTR STE 216
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23451-6131
Country	:	US
Telephone Number	:	757-371-2700
Fax Number	:

Provider Business Practice Location Address
First Line	:	1604 HILLTOP WEST SHOPPING CTR STE 216
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23451-6131
Country	:	US
Telephone Number	:	757-371-2700
Fax Number	:

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

Provider Enumeration Date	:	02/03/2025
Last Update Date	:	05/08/2025

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