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NPI Code Detail

MEDICARE: JANIS ANN BURKHARDT LCSW

MEDICARE: JANIS ANN BURKHARDT LCSW
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
11041C0700XClinical Social WorkerI-06607NM

General Provider Information

NPI Number : 1346284072
Entity Type Code : Individual
Provider Name (Legal Business Name) : JANIS ANN BURKHARDT LCSW
Provider Business Mailing Address
First Line : 100 W GRIGGS AVE
Second Line :
City : LAS CRUCES
State : NM
Zip : 88001-1234
Country : US
Telephone Number : 575-647-2800
Fax Number : 575-647-2898
Provider Business Practice Location Address
First Line : 100 W GRIGGS AVE
Second Line :
City : LAS CRUCES
State : NM
Zip : 88001-1234
Country : US
Telephone Number : 575-647-2800
Fax Number : 575-647-2898
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/15/2006
Last Update Date : 04/29/2013

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Directions to “ JANIS ANN BURKHARDT LCSW” Practice Location

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