MEDICARE: MR. BLAINE G. BURKS L.M.S.W.,CAAC

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
1	101YA0400X	Addiction (Substance Use Disorder) Counselor	6801064874	MI
2	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1174632145
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. BLAINE G. BURKS L.M.S.W.,CAAC

Provider Business Mailing Address
First Line	:	19323 ARDMORE ST
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48235-1704
Country	:	US
Telephone Number	:	313-585-2242
Fax Number	:	313-397-1547

Provider Business Practice Location Address
First Line	:	311 E MARKET ST STE 3
Second Line	:
City	:	LIMA
State	:	OH
Zip	:	45801-4535
Country	:	US
Telephone Number	:	419-222-4474
Fax Number	:	419-222-7044

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/30/2006
Last Update Date	:	06/15/2023

Similar Medicare Providers

1972081719 — MR. CARL CHRISTOPHER BA,CDCA
Practice Location Address:

311 E MARKET ST
LIMA, OH
45801-4535

Practice Phone: 419-222-4474
Practice Fax:

1629144050 — LIMA-URBAN MINORITY ALCOHOLISM AND DRUG ABUSE OUTREACH PROGRAM., INC
Practice Location Address:

311 E MARKET ST FL 3
LIMA, OH
45801-4535

Practice Phone: 419-222-4474
Practice Fax: 419-222-7044

1073666293 — TOSEN, INC.
Practice Location Address:

311 E MARKET ST , SUITE 204
LIMA, OH
45801-4535

Practice Phone: 419-222-4700
Practice Fax: 419-222-4724

1780020719 — MS. LORISSA ANNE MEYER LMT
Practice Location Address:

311 E MARKET ST , 3RD FLOOR
LIMA, OH
45801-4535

Practice Phone: 419-523-9580
Practice Fax:

1093250458 — MS. TEARANY HELMS CDCA
Practice Location Address:

311 E MARKET ST FL 3
LIMA, OH
45801-4535

Practice Phone: 419-222-4474
Practice Fax: 419-222-7044

1891230207 — CASSANDRA L DAVIS
Practice Location Address:

311 E MARKET ST
LIMA, OH
45801-4535

Practice Phone: 419-222-4474
Practice Fax: 419-590-0007

Directions to “ MR. BLAINE G. BURKS L.M.S.W.,CAAC” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.