Provider Demographics
NPI:1932355922
Name:BURKE, KATHLEEN (LPC)
Entity Type:Individual
Prefix:MS
First Name:KATHLEEN
Middle Name:
Last Name:BURKE
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:MS
Other - First Name:KATHLEEN
Other - Middle Name:
Other - Last Name:RADWAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:5 CEDAR CT
Mailing Address - Street 2:
Mailing Address - City:LONG VALLEY
Mailing Address - State:NJ
Mailing Address - Zip Code:07853
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:121 SHELLEY DR STE 2E
Practice Address - Street 2:
Practice Address - City:HACKETTSTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07840-2530
Practice Address - Country:US
Practice Address - Phone:862-324-1232
Practice Address - Fax:908-979-1600
Is Sole Proprietor?:No
Enumeration Date:2008-08-11
Last Update Date:2018-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00160700101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional