Individual
DR. JAMES E BURG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMFT, LMHC, PHD
Contact information
Practice address
6202 CONSTITUTION DR STE D, FORT WAYNE, IN 46804-1583
(260) 432-0066
(260) 432-8503
Mailing address
6202 CONSTITUTION DR STE D, FORT WAYNE, IN 46804-1583
(260) 432-0066
(260) 432-8503
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
35001289A
IN
101YM0800X
Mental Health Counselor
Primary
39000886A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300072445
—
IN
Enumeration date
09/01/2006
Last updated
03/05/2024
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