Individual
LIBBI H BURKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSE
Contact information
Practice address
300 CROOKS ST, GREEN BAY, WI 54301-4527
(920) 436-6800
(920) 432-5966
Mailing address
PO BOX 22308, GREEN BAY, WI 54305-2308
(920) 436-6800
(920) 432-5966
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
19002
WI
101YP2500X
Professional Counselor
4606
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1861011363
—
WI
Enumeration date
04/14/2020
Last updated
01/14/2021
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