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General NPI Number Information
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NPI Number | 1265077127
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Entity Type | Organization
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Legal Business Name | BOBBI J BURG LCSW LLC
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Dates
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Enumeration Date | 11/14/2019
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Last Update Date | 01/25/2021
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Provider Practice Location Address
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Address Line | 305 SW MARKET ST # 8
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City | LEES SUMMIT
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State | MO
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Zip | 64063-2388
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Country | US
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Telephone | 816-702-8778
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Fax | 816-203-4499
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Provider Business Mailing Address
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Address Line | 305 SW MARKET ST # 8
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City | LEES SUMMIT
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State | MO
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Zip | 64063-2388
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Country | US
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Telephone | 816-702-8778
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Fax | 816-203-4499
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Authorized Official
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Title or Position | OWNER
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Name | BOBBI J BURG
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Credential | LCSW
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Telephone | 816-702-8778
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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 |
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License Number State |
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