Provider Demographics
NPI:1073506564
Name:BURGER, JEANNE B (EDD LPC LMFT)
Entity Type:Individual
Prefix:DR
First Name:JEANNE
Middle Name:B
Last Name:BURGER
Suffix:
Gender:F
Credentials:EDD LPC LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:ACADEMY CROSSING MEDICAL PLAZA
Mailing Address - Street 2:3300 ACADEMY AVENUE
Mailing Address - City:PORTSMOUTH
Mailing Address - State:VA
Mailing Address - Zip Code:23703-3205
Mailing Address - Country:US
Mailing Address - Phone:757-483-6404
Mailing Address - Fax:757-483-0737
Practice Address - Street 1:ACADEMY CROSSING MEDICAL PLAZA
Practice Address - Street 2:3300 ACADEMY AVE
Practice Address - City:PORTSMOUTH
Practice Address - State:VA
Practice Address - Zip Code:23703-3205
Practice Address - Country:US
Practice Address - Phone:757-483-6404
Practice Address - Fax:757-483-0737
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701001522101YP2500X
VA0717000013106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA080721OtherSENTARA
VA098009OtherANTHEM