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NPI Code Detail

MEDICARE: KELLY BURKE-CHIRICO LCSW

MEDICARE: KELLY BURKE-CHIRICO LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social WorkerCSW008731GA

General Provider Information

NPI Number : 1033610464
Entity Type Code : Individual
Provider Name (Legal Business Name) : KELLY BURKE-CHIRICO LCSW
Provider Business Mailing Address
First Line : 106 CHASE CT
Second Line :
City : PEACHTREE CITY
State : GA
Zip : 30269-1468
Country : US
Telephone Number : 516-532-1238
Fax Number :
Provider Business Practice Location Address
First Line : 3372 PEACHTREE RD NE STE 115
Second Line :
City : ATLANTA
State : GA
Zip : 30326-1963
Country : US
Telephone Number : 516-532-1238
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/21/2018
Last Update Date : 09/18/2023

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Directions to “ KELLY BURKE-CHIRICO LCSW” Practice Location

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