Provider Demographics
NPI:1134776610
Name:BURKHAMMER, AMELIA JANE (MSW, LICSW)
Entity type:Individual
Prefix:
First Name:AMELIA
Middle Name:JANE
Last Name:BURKHAMMER
Suffix:
Gender:F
Credentials:MSW, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 KENTON DR STE 3
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:WV
Mailing Address - Zip Code:25311-1266
Mailing Address - Country:US
Mailing Address - Phone:304-941-6256
Mailing Address - Fax:
Practice Address - Street 1:300 KENTON DR STE 3
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25311-1266
Practice Address - Country:US
Practice Address - Phone:304-941-6256
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-20
Last Update Date:2025-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVBP009454811041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical