KELLY BURDICK (NPI# 1477823664) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477823664 |
| Entity Type | Individual |
| Full Name | KELLY BURDICK |
| Credential | LCDC |
| Practice Address |
4937 Dilworth Ct Ft Worth TX 76116-8836 |
| Practice Telephone | 8177301482 |
| Mailing Telephone | 8177301482 |
| Enumeration Date | 2012-01-05 |
| Last Update Date | 2012-01-05 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
9848 | TX | Behavioral Health & Social Service Providers |
| Street Address |
4937 DILWORTH CT |
| City | FT WORTH |
| State | TX |
| Zip Code | 76116-8836 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952908980 | William Michael Marshall | Pharmacist | 8600 Camp Bowie Blvd, Forth Worth, TX 76116 | 2020-10-02 |
| 1558843599 | Donnisha Bunting | In Home Supportive Care | 2901 Broadmoor, 1115, Fort Worth, TX 76116 | 2018-09-06 |
| 1588156756 | Bilal Master | Student in an Organized Health Care Education/Training Program | 3309 Riveroad Court, 2515, Ft Worth, TX 76116 | 2018-06-04 |
| 1245769728 | Randall R Williams | Physical Therapist | 6913 Camp Bowie Blvd Suite 141, Fort Worth, TX 76116 | 2017-06-08 |
| 1023543048 | 5th Avenue Grooming Lounge | Prosthetic/Orthotic Supplier | 1201 N Watson Rd., Suite 283, Arlington, TX 76116 | 2017-04-27 |
| 1831647734 | Frisco Neuro Collaborations, Pllc | Physician Assistant | 6387 Camp Bowie Blvd Ste B-640, Fort Worth, TX 76116 | 2016-09-20 |
| 1104288372 | Brown Mobile Dental Pa | Dentist | 8008 Camp Bowie W Blvd, Ste 101, Fort Worth, TX 76116 | 2016-03-25 |
| 1639553431 | Bartholomew A Akubukwe | Pharmacist | 6700 Westfree Way, Fortworth, TX 76116 | 2015-07-13 |
| 1952718868 | Brown Mobile Dental | Dentist | 8008 Camp Bowie Suite 101, Fort Worth, TX 76116 | 2014-07-14 |
| 1275949018 | Emily Sue Danner | Dentist | 6726 Camp Bowie Blvd., Fort Worth, TX 76116 | 2014-07-01 |
| Find all providers in zip 76116 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205314093 | William Allen | Counselor | 1501 E El Paso St, Ft Worth, TX 76102-6700 | 2018-08-02 |
| 1760562326 | Anne M Cummings-bridge | Counselor | 6914 Camp Bowie Blvd, Ft Worth, TX 76116-7117 | 2006-10-17 |
| 1164068797 | Rhonda Mae Lines | Counselor | 700 Hemphill St Ste A, Ft Worth, TX 76104-3105 | 2019-11-19 |
| 1225674948 | Michael Doud | Counselor | 4801 Brentwood Stair Rd Ste 404, Ft Worth, TX 76103-1731 | 2019-11-19 |
| 1952947582 | Joseph Lee Stevenson | Counselor | 700 Hemphill St Ste A, Ft Worth, TX 76104-3105 | 2019-11-19 |
| 1669015590 | Mary Thompson | Counselor | 6733 Camp Bowie Blvd, Ft Worth, TX 76116-7112 | 2019-10-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740881655 | Frances Charline Lee Cole | Counselor | 6238 Raymond Rd, Kaufman, TX 75142-7624 | 2020-11-06 |
| 1063013985 | Kyle Allan Mccall | Counselor | 5015 S Ih 35 Frontage Rd, Suite 200, Austin, TX 78744 | 2020-11-06 |
| 1639770969 | Fadya Therapy Pllc | Counselor | 1452 Wild Basin Ldg, Austin, TX 78746-2700 | 2020-11-03 |
| 1679173728 | Darlene Kearney | Counselor | 2626 S Loop W Ste 174, Houston, TX 77054-2873 | 2020-10-28 |
| 1346849148 | Priscilla Rosas | Counselor | 8431 Chivalry St, San Antonio, TX 78254 | 2020-10-22 |
| 1649879586 | Nicole Trevino | Counselor | 12631 E Clark Rd, La Feria, TX 78559-4528 | 2020-10-21 |
| 1144829060 | Reffitt Counseling, Pllc | Counselor | 301 S Rogers St Ste 106, Waxahachie, TX 75165-3682 | 2020-10-21 |
| 1548868664 | Michelle Villarreal | Counselor | 4720 Box Canyon Dr, Temple, TX 76502-7311 | 2020-10-12 |
| 1275131559 | Debbie Jo Stuard | Counselor | Debbie Stuard Lcdc/ma, 255 Airtex, Houston, TX 77090-7753 | 2020-10-09 |
| 1558968289 | Alexandra Glenn | Counselor | 3310 Louisiana St Apt 2304, Houston, TX 77006-6637 | 2020-10-06 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.