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General NPI Number Information
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NPI Number | 1205124682
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Entity Type | Individual
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Provider Name | CASONDRA BURKLEY LCSW
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Gender | Female
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Dates
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Enumeration Date | 07/19/2011
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Last Update Date | 02/04/2020
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Provider Practice Location Address
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Address Line | 3711 W OREM DR
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City | HOUSTON
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State | TX
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Zip | 77045-4427
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Country | US
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Telephone | 832-418-6152
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 980124
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City | HOUSTON
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State | TX
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Zip | 77098-0124
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Country | US
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Telephone | 832-418-6152
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 50346
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License Number State | TX
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