Provider Demographics
NPI:1790228179
Name:BURKE, TAMI J (MS, LIMHP)
Entity Type:Individual
Prefix:
First Name:TAMI
Middle Name:J
Last Name:BURKE
Suffix:
Gender:F
Credentials:MS, LIMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6606 S 168TH ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68135-5419
Mailing Address - Country:US
Mailing Address - Phone:402-618-2660
Mailing Address - Fax:402-884-7177
Practice Address - Street 1:6606 S 168TH ST
Practice Address - Street 2:SUITE 200
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68135-5419
Practice Address - Country:US
Practice Address - Phone:402-618-2660
Practice Address - Fax:402-884-7177
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-02
Last Update Date:2017-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1831101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health