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General NPI Number Information
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NPI Number | 1750552071
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Entity Type | Individual
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Provider Name | KEVIN CLIFFORD BURKE L.C.S.W.
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Gender | Male
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Dates
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Enumeration Date | 03/13/2008
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Last Update Date | 04/10/2024
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Provider Practice Location Address
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Address Line | 138 W 25TH ST STE 802-B9
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City | NEW YORK
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State | NY
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Zip | 10001-7405
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Country | US
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Telephone | 718-447-2755
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Fax |
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Provider Business Mailing Address
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Address Line | 126 PARK AVE
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City | STATEN ISLAND
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State | NY
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Zip | 10302-1442
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Country | US
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Telephone | 718-720-5439
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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 | 102L00000X
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Taxonomy Name | Psychoanalyst
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License Number | R-050461
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | R-050461
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License Number State | NY
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