Renee K Burke PHD PLLC

Primary specialty

Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X

Legal business name

RENEE K BURKE PHD PLLC

Practice address

4527 S 2300 E Ste 206
Salt Lake City, UT 84117-4501

Phone

(801) 618-7443

NPI assigned

Mar 23, 2021

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Renee Burke, PHDNPI 1386016061

Title

Owner

Phone

(801) 618-7443

Specialties & licenses 1

Addresses

Other names 1

• The Centering Space: Child & Family Therapy Other name

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Renee Kathleen Burke, B.A., M.S., PH.D.

  • Clinical Child & Adolescent Psychologist
  • Salt Lake City, UT
  • NPI 1386016061
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1616457600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1616457600000",
    "number": "1295311850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4527 S 2300 E STE 206",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841174501",
            "telephone_number": "801-618-7443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4527 S 2300 E STE 206",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841174501",
            "telephone_number": "801-618-7443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENEE K BURKE PHD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-23",
        "last_updated": "2021-03-23",
        "certification_date": "2021-03-23",
        "status": "A",
        "authorized_official_last_name": "BURKE",
        "authorized_official_first_name": "RENEE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "801-618-7443",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Centering Space: Child & Family Therapy",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Brock Remington
• Cailey Remington
• Rosemarie Renaud, ACMHC
• Jacqueline A. Rendo, MD
• D'Covany Kalijah Mari Renick
• Dale G Renlund, MD
• David R Renner, MD
• Jamin Rennert
• Abigail Lee Reno

• Clinical Child & Adolescent Psychologist in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Clinical Child & Adolescent Psychologist in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.