Provider Demographics
NPI:1942887625
Name:BURKS, MARVA DAVIS (LPC)
Entity Type:Individual
Prefix:
First Name:MARVA
Middle Name:DAVIS
Last Name:BURKS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5959 WEST LOOP SOUTH SUITE #180
Mailing Address - Street 2:
Mailing Address - City:BELLAIRE
Mailing Address - State:TX
Mailing Address - Zip Code:77401-2420
Mailing Address - Country:US
Mailing Address - Phone:832-951-7816
Mailing Address - Fax:832-626-3556
Practice Address - Street 1:5959 WEST LOOP SOUTH SUITE #180
Practice Address - Street 2:
Practice Address - City:BELLAIRE
Practice Address - State:TX
Practice Address - Zip Code:77401-2420
Practice Address - Country:US
Practice Address - Phone:832-951-7816
Practice Address - Fax:832-626-3556
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-27
Last Update Date:2023-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX79825101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX79825OtherLICENSED PROFESSIONAL COUNSELOR