NPIMap

Organization Active NPI

Burkly Clinical Services, PLLC

  • Professional Counselor
  • Glen Ellyn, IL
National Provider Identifier
1700468386
Registry record updated Apr 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Legal business name
BURKLY CLINICAL SERVICES, PLLC
Practice address
497 N Main St
Glen Ellyn, IL 60137-5171
Phone
(708) 846-6108
NPI assigned
Apr 23, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2021

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

Authorized official

Name
Andrea Burkly, LCPCNPI 1487288015
Title
Owner and Manager
Phone
(708) 846-6108

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YP2500X Primary

Addresses

Primary practice location

497 N Main St
Glen Ellyn, IL 60137-5171

Mailing address

1764 Mustang CT
Wheaton, IL 60189-8483
Phone (708) 846-6108

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1619136000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1619136000000",
    "number": "1700468386",
    "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": {
        "organization_name": "BURKLY CLINICAL SERVICES, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-23",
        "last_updated": "2021-04-23",
        "certification_date": "2021-04-23",
        "status": "A",
        "authorized_official_last_name": "BURKLY",
        "authorized_official_first_name": "ANDREA",
        "authorized_official_title_or_position": "OWNER AND MANAGER",
        "authorized_official_telephone_number": "708-846-6108",
        "authorized_official_credential": "LCPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glen Ellyn, IL

Sources for this page

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