1518262351 NPI number — ELIZABETH BURCH LMSW, LMLP

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1518262351 NPI number — ELIZABETH BURCH LMSW, LMLP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BURCH
Provider First Name:
ELIZABETH
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
LMSW, LMLP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1518262351
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/15/2026
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1832
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PITTSBURG
Provider Business Mailing Address State Name:
KS
Provider Business Mailing Address Postal Code:
66762-1832
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
620-848-2300
Provider Business Mailing Address Fax Number:
620-848-2301

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
801 W 8TH ST
Provider Second Line Business Practice Location Address:
COMMUNITY HEALTH CENTER OF SOUTHEAST KANS
Provider Business Practice Location Address City Name:
COFFEYVILLE
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
67337-6733
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
620-251-4300
Provider Business Practice Location Address Fax Number:
620-251-4979
Provider Enumeration Date:
01/25/2011

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 104100000X , with the licence number:  14484 , registered in the state of KS ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 100098150B , issued by the state of ( KS ) . This identifiers is of the category "MEDICAID".
  • Identifier: 100098150A , issued by the state of ( KS ) . This identifiers is of the category "MEDICAID".




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