Rebecca Ann Burdette, MS, PROFESSIONAL COU
Individual provider Active NPI Counselor · Renosha, WI
NPI 1942492020 · NPPES record last updated Apr 28, 2009
Key facts
- NPI
- 1942492020
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Counselor 101Y00000X
- License
- 240-226 (WI)
- Practice address
- 920 60TH Street
Renosha, WI 53140 - Phone
- (262) 654-5333
- Fax
- (262) 654-7818
- NPI assigned
- Aug 13, 2007
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 240-226 | WI | MD | Health Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Interconnections, SC | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Health Psychologist | 103TH0004X | 240-226 | WI | |
| Counselor | 101Y00000X | 240-226 | WI | Yes |
Addresses
Primary practice location
920 60TH Street
Renosha, WI 53140
Mailing address
920 60TH Street
Renosha, WI 53140
Phone (262) 654-5333
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 42133400 | Medicaid | WI |
Other names
- Ms. Rebecca Ann Pokrop
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 28, 2009. 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.