Individual provider Active NPI

Eileen Burch, LPC INTERN

  • Professional Counselor
  • Beaumont, TX
National Provider Identifier
1356730469
Registry record updated Jan 13, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
72519 Issued in TX
Practice address
Cardinal Community Clinic, Education Building, Room 115
Box 10034
Beaumont, TX 77710
Phone
(409) 880-7681
Fax
(409) 880-2252
NPI assigned
Jan 13, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 72519 TX Primary

Addresses

Primary practice location

Cardinal Community Clinic, Education Building, Room 115
Box 10034
Beaumont, TX 77710

Mailing address

13580 Wayside Dr
Beaumont, TX 77713-8482
Phone (409) 753-1172

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

State licenses

LicenseStateTypeSpecialty
72519TXMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1421107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421107200000",
    "number": "1356730469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13580 WAYSIDE DR",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777138482",
            "telephone_number": "409-753-1172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CARDINAL COMMUNITY CLINIC, EDUCATION BUILDING, ROOM 115",
            "address_2": "BOX 10034",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "77710",
            "telephone_number": "409-880-7681",
            "fax_number": "409-880-2252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURCH",
        "first_name": "EILEEN",
        "name_prefix": "Ms.",
        "credential": "LPC INTERN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-01-13",
        "last_updated": "2015-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "72519",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beaumont, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2015; 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.