Individual
DAVE BURGOON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPCC
Contact information
Practice address
668 BYPASS RD, BRANDENBURG, KY 40108-1730
(270) 305-1820
Mailing address
87 ROLLING CT, EKRON, KY 40117-8649
(270) 305-1820
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
263815
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100694080
—
KY
Enumeration date
07/23/2020
Last updated
04/13/2022
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