Provider Demographics
NPI:1841861689
Name:BUERKLE, TERA (LMFT)
Entity type:Individual
Prefix:
First Name:TERA
Middle Name:
Last Name:BUERKLE
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1711 BARDSTOWN RD STE 201
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40205-2258
Mailing Address - Country:US
Mailing Address - Phone:859-359-8266
Mailing Address - Fax:
Practice Address - Street 1:1711 BARDSTOWN RD STE 201
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40205-2258
Practice Address - Country:US
Practice Address - Phone:859-359-8266
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-02
Last Update Date:2025-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY289138106H00000X
KY271225106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY289138OtherKENTUCKY BOARD OF LICENSURE FOR MARRIAGE AND FAMILY THERAPISTS
1629733936OtherNPI TYPE 2