Provider Demographics
NPI:1669806790
Name:BURBA, KERA CHRISTINE (MS, LPCC)
Entity type:Individual
Prefix:MRS
First Name:KERA
Middle Name:CHRISTINE
Last Name:BURBA
Suffix:
Gender:F
Credentials:MS, LPCC
Other - Prefix:
Other - First Name:KERA
Other - Middle Name:CHRISTINE
Other - Last Name:WALTERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:318 REGENCY RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:CENTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45459-4251
Mailing Address - Country:US
Mailing Address - Phone:937-477-8416
Mailing Address - Fax:
Practice Address - Street 1:318 REGENCY RIDGE DR
Practice Address - Street 2:
Practice Address - City:CENTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:45459-4251
Practice Address - Country:US
Practice Address - Phone:937-477-8416
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-26
Last Update Date:2024-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE.1901437101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional