Provider Demographics
NPI:1376717884
Name:BUERCKHOLTZ, HARRIETT HALE (LPC)
Entity Type:Individual
Prefix:
First Name:HARRIETT
Middle Name:HALE
Last Name:BUERCKHOLTZ
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 759194
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21275-9194
Mailing Address - Country:US
Mailing Address - Phone:540-710-6085
Mailing Address - Fax:
Practice Address - Street 1:1316 PATTON AVE
Practice Address - Street 2:D
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28806-2666
Practice Address - Country:US
Practice Address - Phone:828-225-3100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-15
Last Update Date:2015-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5175OtherNC STATE LICENSE