Provider Demographics
NPI:1285349662
Name:BURGARD, REBECCA (LCSW)
Entity type:Individual
Prefix:MISS
First Name:REBECCA
Middle Name:
Last Name:BURGARD
Suffix:
Gender:
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:541 BUTTERMILK PIKE STE 200
Mailing Address - Street 2:
Mailing Address - City:CRESCENT SPRINGS
Mailing Address - State:KY
Mailing Address - Zip Code:41017-1696
Mailing Address - Country:US
Mailing Address - Phone:859-869-2023
Mailing Address - Fax:
Practice Address - Street 1:541 BUTTERMILK PIKE STE 200
Practice Address - Street 2:
Practice Address - City:CRESCENT SPRINGS
Practice Address - State:KY
Practice Address - Zip Code:41017-1696
Practice Address - Country:US
Practice Address - Phone:859-869-2023
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-19
Last Update Date:2025-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY2601531041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical