MEDICARE: MS. DARLENE C BURKE 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
1	1041C0700X	Clinical Social Worker	445C05406100	NJ
2	1041C0700X	Clinical Social Worker	R036531	NY
3	1041C0700X	Clinical Social Worker	R036531-01	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1700866878
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. DARLENE C BURKE LCSW

Provider Business Mailing Address
First Line	:	1357 KINGS HIGHWAY, PO BOX 5
Second Line	:
City	:	SUGAR LOAF
State	:	NY
Zip	:	10981-0005
Country	:	US
Telephone Number	:	845-469-6266
Fax Number	:	845-469-6266

Provider Business Practice Location Address
First Line	:	1357 KINGS HIGHWAY
Second Line	:
City	:	SUGAR LOAF
State	:	NY
Zip	:	10981-0005
Country	:	US
Telephone Number	:	845-469-6266
Fax Number	:	845-469-6266

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/17/2006
Last Update Date	:	01/24/2024

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