Provider Demographics
NPI:1831912526
Name:BURKETT, SAMISHA (LMFT ASSOCIATE)
Entity type:Individual
Prefix:MRS
First Name:SAMISHA
Middle Name:
Last Name:BURKETT
Suffix:
Gender:F
Credentials:LMFT ASSOCIATE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3563 PAGANINI PL
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77493-3275
Mailing Address - Country:US
Mailing Address - Phone:346-435-8368
Mailing Address - Fax:
Practice Address - Street 1:3563 PAGANINI PL
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77493-3275
Practice Address - Country:US
Practice Address - Phone:346-435-8368
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-01
Last Update Date:2024-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX205764106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist