Provider Demographics
NPI:1477191229
Name:BURKHARD, STEPHANIE KRISTEN (MA, QMHP)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:KRISTEN
Last Name:BURKHARD
Suffix:
Gender:F
Credentials:MA, QMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:424 WARDS CORNER RD STE 200
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:45140-6966
Mailing Address - Country:US
Mailing Address - Phone:513-707-4041
Mailing Address - Fax:513-576-1020
Practice Address - Street 1:150 HEALTH PARTNERS CIR
Practice Address - Street 2:
Practice Address - City:MOUNT ORAB
Practice Address - State:OH
Practice Address - Zip Code:45154-8610
Practice Address - Country:US
Practice Address - Phone:937-444-2514
Practice Address - Fax:937-444-4818
Is Sole Proprietor?:No
Enumeration Date:2019-12-11
Last Update Date:2024-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist