Katherine E Burke, SAC-IT
Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Viroqua, WI
NPI 1821362831 · NPPES record last updated Mar 8, 2012
Key facts
- NPI
- 1821362831
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Addiction (Substance Use Disorder) Counselor 101YA0400X
- License
- 16412-130 (WI)
- Practice address
- 210 Airport Rd
Suite 103
Viroqua, WI 54665-1159 - Phone
- (608) 638-7420
- Fax
- (608) 638-7429
- NPI assigned
- Mar 8, 2012
- Sex
- Female
- 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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 16412-130 | WI | MD | Addiction (Substance Use Disorder) Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 16412-130 | WI | Yes |
Addresses
Primary practice location
210 Airport Rd
Suite 103
Viroqua, WI 54665-1159
Mailing address
210 Airport Rd
Suite 103
Viroqua, WI 54665-1159
Phone (608) 638-7420
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 16412-130 | Other | WI | SAC-IT |
Other providers in Viroqua, WI
- Jenelle Boyer
- Yvonne M Brault
- Terrie Braun-Johnson
- David R Breitbach
- Kristine K Brueggen
- Cheryl Cade
- Jenny Lee Cain
- Laura Carol Cavanaugh
- Center Point Counseling Services Cooperative
- Center Point Counseling Services Emhs
All providers in Viroqua, WI · Addiction (Substance Use Disorder) Counselor in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 8, 2012. 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.