Provider Demographics
NPI:1629638036
Name:BURGE, ANNA MAUREEN (LPC)
Entity Type:Individual
Prefix:MS
First Name:ANNA
Middle Name:MAUREEN
Last Name:BURGE
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:ANNA
Other - Middle Name:MAUREEN
Other - Last Name:SAAIDI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:12503 SW 3RD ST
Mailing Address - Street 2:
Mailing Address - City:YUKON
Mailing Address - State:OK
Mailing Address - Zip Code:73099-6107
Mailing Address - Country:US
Mailing Address - Phone:405-227-4906
Mailing Address - Fax:
Practice Address - Street 1:300 S RANCHWOOD BLVD STE 11
Practice Address - Street 2:
Practice Address - City:YUKON
Practice Address - State:OK
Practice Address - Zip Code:73099-2745
Practice Address - Country:US
Practice Address - Phone:405-492-6230
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-18
Last Update Date:2021-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK7766101Y00000X, 101YP2500X, 101YM0800X
101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional