Provider Demographics
NPI:1346599115
Name:BURKE, ASHLEY A (MA LMHP)
Entity Type:Individual
Prefix:MRS
First Name:ASHLEY
Middle Name:A
Last Name:BURKE
Suffix:
Gender:F
Credentials:MA LMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12834 LILLIAN ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68138-6034
Mailing Address - Country:US
Mailing Address - Phone:402-980-7650
Mailing Address - Fax:
Practice Address - Street 1:4917 UNDERWOOD AVE
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68132-2421
Practice Address - Country:US
Practice Address - Phone:402-980-7650
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-07
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE4923101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE470398819Medicaid