Provider Demographics
NPI:1043643844
Name:BURKS COUNSELING, PLLC
Entity Type:Organization
Organization Name:BURKS COUNSELING, PLLC
Other - Org Name:ALL WITHIN HEALING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:COUNSELOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:BURKS
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:208-841-2641
Mailing Address - Street 1:1674 W HILL RD
Mailing Address - Street 2:SUITE 17
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83702-0958
Mailing Address - Country:US
Mailing Address - Phone:208-841-2641
Mailing Address - Fax:
Practice Address - Street 1:1674 W HILL RD
Practice Address - Street 2:SUITE 17
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83702-0958
Practice Address - Country:US
Practice Address - Phone:208-841-2641
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-15
Last Update Date:2013-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLPC5032305R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization