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NPI Code Detail

MEDICARE: CHRISTINE M. BURBANK M.S.W.

MEDICARE:   CHRISTINE M. BURBANK  M.S.W.
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 Worker1025768MA

General Provider Information

NPI Number : 1528121837
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHRISTINE M. BURBANK M.S.W.
Provider Business Mailing Address
First Line : 440 SOUTH ST
Second Line :
City : PITTSFIELD
State : MA
Zip : 01201-8243
Country : US
Telephone Number : 413-499-5258
Fax Number : 413-499-3974
Provider Business Practice Location Address
First Line : 440 SOUTH ST
Second Line :
City : PITTSFIELD
State : MA
Zip : 01201-8243
Country : US
Telephone Number : 413-499-5258
Fax Number : 413-499-3974
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/18/2006
Last Update Date : 07/08/2007

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Directions to “ CHRISTINE M. BURBANK M.S.W.” Practice Location

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