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Individual

JEFFRY BURGDORFER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LPC

Contact information

Practice address
68 POINTE CIR STE 3201, GREENVILLE, SC 29615-6307
(864) 301-6458
Mailing address
68 POINTE CIR STE 3201, GREENVILLE, SC 29615-6307

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
3111
CT
101YP2500X
Professional Counselor
Primary
7521
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
008023170
CT
05
008024427
CT
05
008039745
CT
05
008070148
CT
Enumeration date
01/11/2017
Last updated
01/17/2024
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