| Doctor Name: | SAMANTHA KIMBERLY BURKHARDT |
| NPI Number: | 1326318247 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | CRC, LPC |
| License Number: | PC006195 |
| Business Practice Address: | 406 N State St Clarks Summit, PA - 184111062 |
| Business Phone Number: | 5703428434 |
| Business Fax Number: | |
| Mailing Address: | 406 N State St, CLARKS SUMMIT |
| State: | PA |
| Postal Code: | 184111062 |
| Phone Number: | 5703428434 |
| Fax Number: | |
| NPI Enumeration Date: | 01/09/2012 |
| NPI Last Update Date: | 03/11/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | PC006195 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |