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NPI Code Detail

MEDICARE: MR. THOMAS JAMES BURKE MA, LMSW, CAC-I

MEDICARE: MR. THOMAS JAMES BURKE MA, LMSW, CAC-I
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1104100000XSocial Worker6801013106MI

General Provider Information

NPI Number : 1104952522
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. THOMAS JAMES BURKE MA, LMSW, CAC-I
Provider Business Mailing Address
First Line : 330 W MICHIGAN AVE
Second Line :
City : JACKSON
State : MI
Zip : 49201-2121
Country : US
Telephone Number : 517-787-7920
Fax Number : 517-787-2440
Provider Business Practice Location Address
First Line : 330 W MICHIGAN AVE
Second Line :
City : JACKSON
State : MI
Zip : 49201-2121
Country : US
Telephone Number : 517-787-7920
Fax Number : 517-787-2440
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/27/2007
Last Update Date : 07/08/2007

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Directions to “ MR. THOMAS JAMES BURKE MA, LMSW, CAC-I” Practice Location

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