Andrea Burkly, LCPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

497 N Main St
Glen Ellyn, IL 60137-5171

Phone

(708) 846-6108

NPI assigned

Feb 21, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Burkly Clinical Services, PLLC

  • Professional Counselor
  • Glen Ellyn, IL
  • NPI 1700468386
  NPD Authorized official
• Marvelous Minds, Inc

  • Mental Health Counselor
  • Glen Ellyn, IL
  • NPI 1902319916
  NPD (past)

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

{
    "created_epoch": "1582243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640217600000",
    "number": "1487288015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1764 MUSTANG CT",
            "city": "WHEATON",
            "state": "IL",
            "postal_code": "601898483",
            "telephone_number": "708-846-6108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "497 N MAIN ST",
            "city": "GLEN ELLYN",
            "state": "IL",
            "postal_code": "601375171",
            "telephone_number": "708-846-6108"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURKLY",
        "first_name": "ANDREA",
        "credential": "LCPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-02-21",
        "last_updated": "2021-12-23",
        "certification_date": "2021-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeremy Peter Buishas, D.V.M.
• Kyle Jeffrey Bulseco, PT, DPT
• Stephen P Bunjes, PTA
• Linda A. Burba, AU.D.
• Burkly Clinical Services, PLLC
• Mary Beth Bush, PT
• Kathryn Nicole Caccamo
• Shannon Marie Cagle, LCPC
• Yazmin Camarena, M.S.
• Jacquelyn Cameli, PT, DPT

• Mental Health Counselor in Glen Ellyn, IL
• Providers in Glen Ellyn, IL by specialty
• Mental Health Counselor in Illinois

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