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General NPI Number Information
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NPI Number | 1386259364
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Entity Type | Individual
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Provider Name | STEFANIE NIKOLE BURKE LCSW, MSSW
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Gender | Female
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Dates
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Enumeration Date | 09/15/2020
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Last Update Date | 11/24/2020
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Provider Practice Location Address
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Address Line | 8500 N MOPAC EXPY STE 601
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City | AUSTIN
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State | TX
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Zip | 78759-8347
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Country | US
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Telephone | 512-270-0272
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Fax |
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Provider Business Mailing Address
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Address Line | 3607 S LAMAR BLVD APT 1420
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City | AUSTIN
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State | TX
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Zip | 78704-0391
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Country | US
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Telephone | 512-669-9162
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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 | 61382
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License Number State | TX
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