Provider Demographics
NPI:1912070913
Name:BURKE, JENNIFER JEAN (LMHC)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:JEAN
Last Name:BURKE
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1551
Mailing Address - Street 2:
Mailing Address - City:MEREDITH
Mailing Address - State:NH
Mailing Address - Zip Code:03253-1551
Mailing Address - Country:US
Mailing Address - Phone:603-726-6793
Mailing Address - Fax:
Practice Address - Street 1:954 WHITTIER HIGHWAY
Practice Address - Street 2:
Practice Address - City:MOULTONBOROUGH
Practice Address - State:NH
Practice Address - Zip Code:03254
Practice Address - Country:US
Practice Address - Phone:603-726-6793
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-16
Last Update Date:2020-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH824101YM0800X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health