| Doctor Name: | STEPHANIE BURKES |
| NPI Number: | 1043614613 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LCSW |
| License Number: | |
| Business Practice Address: | 3292 County Road 220 Middleburg, FL - 320684357 |
| Business Phone Number: | 9042915561 |
| Business Fax Number: | 9042915575 |
| Mailing Address: | 1726 Kingsley Ave, Suite 2 ORANGE PARK |
| State: | FL |
| Postal Code: | 320734463 |
| Phone Number: | 9042785644 |
| Fax Number: | 9042785659 |
| NPI Enumeration Date: | 10/10/2014 |
| NPI Last Update Date: | 10/10/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |