Michael David Burkholder, MA, LMFT
Individual provider Active NPI Marriage & Family Therapist · Coeur D Alene, ID
NPI 1629353057 · NPPES record last updated Oct 17, 2011
Key facts
- NPI
- 1629353057
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Marriage & Family Therapist 106H00000X
- License
- LMFT 2680 (ID)
- Practice address
- 1034 N 3Rd St
Suite 5-B
Coeur D Alene, ID 83814-3145 - Phone
- (208) 667-9145
- NPI assigned
- Oct 17, 2011
- Sex
- Male
- 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
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LMFT 2680 | ID | MD | Marriage & Family Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | LMFT 2680 | ID | Yes |
Addresses
Primary practice location
1034 N 3Rd St
Suite 5-B
Coeur D Alene, ID 83814-3145
Mailing address
1034 N 3Rd St
Suite 5-B
Coeur D Alene, ID 83814-3145
Phone (208) 667-9145
Other providers in Coeur D Alene, ID
- Heidi Burk
- Savannah Elizabeth Burk
- Lyudmila Burkart
- Scott Andrew Burke
- Jimmy Louis Burkhard
- Robert J Burnett
- Rheanna Burnham
- Melissa C Burns-Price
- Brittany Carleton Burns
- Madeleine Regina Burns
All providers in Coeur D Alene, ID · Marriage & Family Therapist in Idaho
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 17, 2011. 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.