=====================================================
General NPI Number Information
=====================================================
NPI Number | 1649089343
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | BRITTANY A BURKE LMSW
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/06/2025
-----------------------------------------------------
Last Update Date | 01/06/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2081 COLLIER CORPORATE PKWY
-----------------------------------------------------
City | SAINT CHARLES
-----------------------------------------------------
State | MO
-----------------------------------------------------
Zip | 63303-6701
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 636-255-0002
-----------------------------------------------------
Fax | 636-634-4777
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2081 COLLIER CORPORATE PKWY
-----------------------------------------------------
City | SAINT CHARLES
-----------------------------------------------------
State | MO
-----------------------------------------------------
Zip | 63303-6701
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 636-255-0002
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 104100000X
-----------------------------------------------------
Taxonomy Name | Social Worker
-----------------------------------------------------
License Number | 2023043210
-----------------------------------------------------
License Number State | MO
-----------------------------------------------------