Active NPI
Judy Burgeis, MA
- Marriage & Family Therapist
- Centralia, WA
National Provider Identifier
1124478748
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- I DO NOT HAVE A LIC
- Practice address
- 1604 Military Rd
Centralia, WA 98531-9015 - Phone
- (360) 736-5558
- NPI assigned
- Jun 14, 2016
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | I DO NOT HAVE A LIC | WA | Primary |
Addresses
Primary practice location
1604 Military Rd
Centralia, WA 98531-9015
Mailing address
1604 Military Rd
Centralia, WA 98531-9015
Phone (360) 736-5558
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| I DO NOT HAVE A LIC | WA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1465862400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1465862400000",
"number": "1124478748",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1604 MILITARY RD",
"city": "CENTRALIA",
"state": "WA",
"postal_code": "985319015",
"telephone_number": "360-736-5558"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1604 MILITARY RD",
"city": "CENTRALIA",
"state": "WA",
"postal_code": "985319015",
"telephone_number": "360-736-5558"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BURGEIS",
"first_name": "JUDY",
"credential": "MA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-06-14",
"last_updated": "2016-06-14",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "WA",
"license": "I DO NOT HAVE A LIC",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Centralia, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.