Organization
PEAK PATHWAYS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VICKI SUSAN BURGESS LPCC (PRIMARY)
(701) 941-0175
Entity
Organization
Contact information
Practice address
3523 45TH ST S, FARGO, ND 58104-8962
(701) 941-0175
(701) 941-3001
Mailing address
4160 24TH AVE S STE 102, FARGO, ND 58104-9038
(701) 941-0175
(701) 941-3001
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
113561521545
STATE LICENSE
ND
Enumeration date
11/08/2023
Last updated
11/08/2023
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