MEDICARE: HEIDI BURGESS

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	106H00000X	Marriage & Family Therapist

General Provider Information

NPI Number	:	1720937485
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HEIDI BURGESS

Provider Business Mailing Address
First Line	:	9353 W TWAIN AVE APT 189
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89147-6867
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	8872 S EASTERN AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89123-4900
Country	:	US
Telephone Number	:	725-243-6644
Fax Number	:

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

Provider Enumeration Date	:	01/26/2026
Last Update Date	:	01/26/2026

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Directions to “ HEIDI BURGESS ” Practice Location

Language	Start Address	Practice Location

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