Dave Burgoon, LPCC
Individual provider Active NPI Mental Health Counselor · Brandenburg, KY
NPI 1396354536 · NPPES record last updated Apr 13, 2022
Key facts
- NPI
- 1396354536
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- License
- 263815 (KY)
- Practice address
- 668 Bypass Rd
Brandenburg, KY 40108-1730 - Phone
- (270) 305-1820
- NPI assigned
- Jul 23, 2020
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
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 |
|---|---|---|---|
| 263815 | KY | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Everlasting Hope Family Counseling | Current |
Accepting new patients | |
| Everlasting Arms Family Counseling Center, LLC | Mental Health | Past |
Accepting new patients |
Locations
668 Bypass Rd
Brandenburg, KY 40108
Phone (270) 305-1820
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 263815 | KY | Yes |
Addresses
Primary practice location
668 Bypass Rd
Brandenburg, KY 40108-1730
Mailing address
87 Rolling CT
Ekron, KY 40117-8649
Phone (270) 305-1820
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7100694080 | Medicaid | KY |
Other providers in Brandenburg, KY
- Bridgette Ann Brown
- Marquita Lytrese Brown
- Markeesha Danielle Bruner
- Dana Carol Buren
- Alicia Burgess
- Carla Burns
- Kandace Burton
- Alecia Nicole Byassee
- Cardiac Care Center of Louisville, PLLC
- Carl W. Sydnor
All providers in Brandenburg, KY · Mental Health Counselor in Kentucky
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 13, 2022. 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.