Provider Demographics
NPI:1598307118
Name:BURKE, KELLI (MSED, LPC)
Entity Type:Individual
Prefix:
First Name:KELLI
Middle Name:
Last Name:BURKE
Suffix:
Gender:F
Credentials:MSED, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:603 WASHINGTON RD
Mailing Address - Street 2:STE 300
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15228-1928
Mailing Address - Country:US
Mailing Address - Phone:412-563-6151
Mailing Address - Fax:412-344-3780
Practice Address - Street 1:603 WASHINGTON RD
Practice Address - Street 2:STE 300
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15228-1928
Practice Address - Country:US
Practice Address - Phone:412-563-6151
Practice Address - Fax:412-344-3780
Is Sole Proprietor?:No
Enumeration Date:2019-10-15
Last Update Date:2021-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC011508101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health