Healthcare Provider Details

I. General information

NPI: 1588104087
Provider Name (Legal Business Name): ALLISON BURKE MSW, LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/02/2017
Last Update Date: 07/29/2021
Certification Date: 07/29/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

315 S UTICA AVE
TULSA OK
74104-2203
US

IV. Provider business mailing address

6216 S LEWIS AVE STE 180
TULSA OK
74136-1077
US

V. Phone/Fax

Practice location:
  • Phone: 918-594-4726
  • Fax: 918-594-4713
Mailing address:
  • Phone: 918-960-7852
  • Fax: 539-664-5738

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number5172
License Number StateOK
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number7609
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: