Provider Demographics
NPI:1568204899
Name:BURCKHARDT, CHARLES N SR (LPC)
Entity type:Individual
Prefix:MR
First Name:CHARLES
Middle Name:N
Last Name:BURCKHARDT
Suffix:SR
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1639 BRYNNE LN
Mailing Address - Street 2:
Mailing Address - City:POTTSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19464-1475
Mailing Address - Country:US
Mailing Address - Phone:267-408-9335
Mailing Address - Fax:
Practice Address - Street 1:1639 BRYNNE LN
Practice Address - Street 2:
Practice Address - City:POTTSTOWN
Practice Address - State:PA
Practice Address - Zip Code:19464-1475
Practice Address - Country:US
Practice Address - Phone:267-408-9335
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-07
Last Update Date:2024-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC014266101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health