Provider Demographics
NPI:1891948618
Name:BURCH, LAKIMBERLY RENE (LPC)
Entity type:Individual
Prefix:
First Name:LAKIMBERLY
Middle Name:RENE
Last Name:BURCH
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 1:3930 BROAD RIVER RD APT Y6
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29210-4714
Mailing Address - Country:US
Mailing Address - Phone:803-629-2626
Mailing Address - Fax:
Practice Address - Street 1:3930 BROAD RIVER RD APT Y6
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29210-4714
Practice Address - Country:US
Practice Address - Phone:803-629-2626
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-23
Last Update Date:2008-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4908101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health