Provider Demographics
NPI:1851450167
Name:BURKE, KRISTEN ANN (LMHC)
Entity Type:Individual
Prefix:MRS
First Name:KRISTEN
Middle Name:ANN
Last Name:BURKE
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:55 OPOSSUM DR
Mailing Address - Street 2:
Mailing Address - City:CHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03036-8114
Mailing Address - Country:US
Mailing Address - Phone:603-887-3342
Mailing Address - Fax:
Practice Address - Street 1:430 N CANAL ST
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:MA
Practice Address - Zip Code:01840-1246
Practice Address - Country:US
Practice Address - Phone:978-683-9505
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA4750101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional