Individual provider Active NPI

Patricia Elizabeth Burke, PHD

  • Counseling Psychologist
  • Flagstaff, AZ
National Provider Identifier
1992767446
Registry record updated May 28, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Counseling PsychologistTaxonomy code 103TC1900X
License
3331 Issued in AZ
Practice address
408 N Kendrick St
Suite 3
Flagstaff, AZ 86001-1582
Phone
(928) 774-6363
Fax
(928) 556-0504
NPI assigned
Apr 3, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 28, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counseling Psychologist 103TC1900X 3331 AZ Primary

Addresses

Primary practice location

408 N Kendrick St
Suite 3
Flagstaff, AZ 86001-1582

Mailing address

408 N Kendrick St
Suite 3
Flagstaff, AZ 86001-1582
Phone (928) 774-6363

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
3331AZMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Flagstaff Child & Family Counseling Center PLLC PastSince Sep 30, 2002 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1144022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1211932800000",
    "number": "1992767446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "408 N KENDRICK ST",
            "address_2": "SUITE 3",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860011582",
            "telephone_number": "928-774-6363",
            "fax_number": "928-556-0504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "408 N KENDRICK ST",
            "address_2": "SUITE 3",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860011582",
            "telephone_number": "928-774-6363",
            "fax_number": "928-556-0504"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURKE",
        "first_name": "PATRICIA",
        "middle_name": "ELIZABETH",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-03",
        "last_updated": "2008-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "AZ",
            "license": "3331",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flagstaff, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2008; 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.