Individual
NICOLE BURDEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
217 WISCONSIN AVE STE 211, WAUKESHA, WI 53186-4946
(414) 877-4570
(142) 819-8844
Mailing address
8045 S MONA DR, OAK CREEK, WI 53154-3033
(414) 840-1583
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
11264
WI
101YM0800X
Mental Health Counselor
7217
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11264
LICENSE
WI
01
—
7217
LICENSE
WI
Enumeration date
01/30/2023
Last updated
09/25/2024
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