Dianna Elizabeth Burgess, L.P.C.C.
Individual provider Active NPI Counselor · Covington, OH
NPI 1346697620 · NPPES record last updated May 17, 2016
Key facts
- NPI
- 1346697620
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Counselor 101Y00000X
- License
- C.0900412 (OH)
- Practice address
- 129 N Pearl St
Covington, OH 45318-1611 - Phone
- (937) 573-6051
- Fax
- (937) 473-3184
- NPI assigned
- May 17, 2016
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C.0900412 | OH | MD | Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | C.0900412 | OH | Yes |
Addresses
Primary practice location
129 N Pearl St
Covington, OH 45318-1611
Mailing address
129 N Pearl St
Covington, OH 45318-1611
Phone (937) 573-6051
Other providers in Covington, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 17, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.