Doctor Name: | WALTER J BURKE |
NPI Number: | 1821288846 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LMHC |
License Number: | 6316 |
Business Practice Address: | 111 Edgartown Rd Oak Bluffs, MA - 02557 |
Business Phone Number: | 5086937900 |
Business Fax Number: | 5086960401 |
Mailing Address: | 111 Edgartown Rd, VINEYARD HAVEN |
State: | MA |
Postal Code: | 025685601 |
Phone Number: | 5086937900 |
Fax Number: | 5086960401 |
NPI Enumeration Date: | 07/26/2007 |
NPI Last Update Date: | 07/26/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | 6316 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |