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Individual
COURTNEY JO BURGAD-WIFALL
Active
Individual
COURTNEY JO BURGAD-WIFALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1928
ND
104100000X
Social Worker
4979
ND
1041C0700X
Clinical Social Worker
4979
ND
Other
Enumeration date
11/27/2015
Last updated
03/25/2026
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