Provider Demographics
NPI:1699071902
Name:BURKEY, GLORIA HOSTETLER (BS, MA, LPC)
Entity type:Individual
Prefix:
First Name:GLORIA
Middle Name:HOSTETLER
Last Name:BURKEY
Suffix:
Gender:F
Credentials:BS, MA, LPC
Other - Prefix:
Other - First Name:GLORIA
Other - Middle Name:DAWNE
Other - Last Name:COTCKEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BS, MA
Mailing Address - Street 1:8320 PENNSYLVANIA AVE.
Mailing Address - Street 2:GRACE WELLNESS CENTER
Mailing Address - City:NORTH HUNTINGDON
Mailing Address - State:PA
Mailing Address - Zip Code:15642
Mailing Address - Country:US
Mailing Address - Phone:724-863-7223
Mailing Address - Fax:724-863-8320
Practice Address - Street 1:8320 PENNSYLVANIA AVE.
Practice Address - Street 2:GRACE WELLNESS CENTER
Practice Address - City:NORTH HUNTINGDON
Practice Address - State:PA
Practice Address - Zip Code:15642
Practice Address - Country:US
Practice Address - Phone:724-863-7223
Practice Address - Fax:724-863-8320
Is Sole Proprietor?:No
Enumeration Date:2011-02-03
Last Update Date:2011-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC003039101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional