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General NPI Number Information
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NPI Number | 1750781464
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Entity Type | Individual
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Provider Name | MS. TREASURE BURKE
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Gender | Female
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Dates
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Enumeration Date | 08/29/2014
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Last Update Date | 06/15/2024
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Provider Practice Location Address
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Address Line | 501 S 54TH ST
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City | PHILADELPHIA
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State | PA
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Zip | 19143-1900
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Country | US
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Telephone | 215-590-4357
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Fax |
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Provider Business Mailing Address
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Address Line | 3401 CIVIC CENTER BLVD
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City | PHILADELPHIA
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State | PA
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Zip | 19104-4319
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Country | US
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Telephone |
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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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 | 44SC06072100
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License Number State | NJ
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | CW024674
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License Number State | PA
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