Organization
NICOLE BURDEN COUNSELING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NICOLE E BURDEN LPC (LICENSED PROFESSIONAL COUNSELOR)
(414) 840-1583
Entity
Organization
Contact information
Practice address
8045 S MONA DR, OAK CREEK, WI 53154-3033
(414) 840-1583
Mailing address
8045 S MONA DR, OAK CREEK, WI 53154-3033
(414) 840-1583
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100231354
—
WI
01
—
11264
LICENSE
WI
Enumeration date
09/25/2024
Last updated
10/10/2024
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