Provider Demographics
NPI:1063430155
Name:BURKHARD, DAVID J (LMFT, LCSW, LMHC)
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:J
Last Name:BURKHARD
Suffix:
Gender:M
Credentials:LMFT, LCSW, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7110 S EAST ST
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46227-8517
Mailing Address - Country:US
Mailing Address - Phone:317-883-1476
Mailing Address - Fax:317-883-1476
Practice Address - Street 1:7110 S EAST ST
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46227-8517
Practice Address - Country:US
Practice Address - Phone:317-883-1476
Practice Address - Fax:317-883-1476
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN39000584A101YM0800X
IN34002563A1041C0700X
IN35000883A106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist