Provider Demographics
NPI:1306667464
Name:BURCH, ELIZABETH (LMFT-A, LPC-A)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:BURCH
Suffix:
Gender:F
Credentials:LMFT-A, LPC-A
Other - Prefix:
Other - First Name:LIZ
Other - Middle Name:
Other - Last Name:BURCH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 286
Mailing Address - Street 2:
Mailing Address - City:BARKER
Mailing Address - State:TX
Mailing Address - Zip Code:77413-0286
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 286
Practice Address - Street 2:
Practice Address - City:BARKER
Practice Address - State:TX
Practice Address - Zip Code:77413-0286
Practice Address - Country:US
Practice Address - Phone:832-303-2465
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-22
Last Update Date:2024-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX205635106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist