Provider Demographics
NPI:1578652053
Name:BURKE, RACHEL (PSYD)
Entity Type:Individual
Prefix:DR
First Name:RACHEL
Middle Name:
Last Name:BURKE
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:55 MERIDIAN PKWY
Mailing Address - Street 2:SUITE 103
Mailing Address - City:MARTINSBURG
Mailing Address - State:WV
Mailing Address - Zip Code:25404-5422
Mailing Address - Country:US
Mailing Address - Phone:304-260-8808
Mailing Address - Fax:304-901-4436
Practice Address - Street 1:55 MERIDIAN PKWY
Practice Address - Street 2:SUITE 103
Practice Address - City:MARTINSBURG
Practice Address - State:WV
Practice Address - Zip Code:25404-5422
Practice Address - Country:US
Practice Address - Phone:304-260-8808
Practice Address - Fax:304-901-4436
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-12
Last Update Date:2018-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV1088103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical