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General NPI Number Information
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NPI Number | 1487023230
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Entity Type | Individual
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Provider Name | CHRISTINE BURGESS LICSW
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Gender | Female
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Dates
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Enumeration Date | 09/23/2015
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Last Update Date | 09/23/2015
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Provider Practice Location Address
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Address Line | 180 LOWE STREET COUNTY CENTER FOR HEALTH REHABILITATION
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City | NEWBURYPORT
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State | MA
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Zip | 01950
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Country | US
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Telephone | 978-465-5361
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Fax |
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Provider Business Mailing Address
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Address Line | 25 RED OAK ACRES ST
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City | MERRIMAC
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State | MA
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Zip | 01860-1533
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Country | US
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Telephone | 978-346-8088
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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 | 118942
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License Number State | MA
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