Provider Demographics
NPI:1225746662
Name:BURGOS, KAREN KINGERA (LPC)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:KINGERA
Last Name:BURGOS
Suffix:
Gender:F
Credentials:LPC
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 1945
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28402
Mailing Address - Country:US
Mailing Address - Phone:910-341-4556
Mailing Address - Fax:866-363-8330
Practice Address - Street 1:337 BRUCE V. MOORE BUILDING
Practice Address - Street 2:
Practice Address - City:UNIVERSITY PARK
Practice Address - State:PA
Practice Address - Zip Code:16802-3103
Practice Address - Country:US
Practice Address - Phone:814-865-9121
Practice Address - Fax:814-863-1331
Is Sole Proprietor?:No
Enumeration Date:2022-11-14
Last Update Date:2022-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC015056101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health