Provider Demographics
NPI:1013399708
Name:BURKET, REBEKAH L (PHD)
Entity Type:Individual
Prefix:MS
First Name:REBEKAH
Middle Name:L
Last Name:BURKET
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 82264
Mailing Address - Street 2:
Mailing Address - City:FAIRBANKS
Mailing Address - State:AK
Mailing Address - Zip Code:99708-2264
Mailing Address - Country:US
Mailing Address - Phone:907-378-8702
Mailing Address - Fax:907-328-4006
Practice Address - Street 1:565 UNIVERSITY AVE STE 4E
Practice Address - Street 2:
Practice Address - City:FAIRBANKS
Practice Address - State:AK
Practice Address - Zip Code:99709-3688
Practice Address - Country:US
Practice Address - Phone:907-378-8702
Practice Address - Fax:907-328-4006
Is Sole Proprietor?:No
Enumeration Date:2015-06-18
Last Update Date:2022-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK936101YM0800X
AK124877103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health