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NPI Code Detail

MEDICARE: EMILY BURCHAM LLMSW

MEDICARE: EMILY BURCHAM LLMSW
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 Worker6851107950MI

General Provider Information

NPI Number : 1184350522
Entity Type Code : Individual
Provider Name (Legal Business Name) : EMILY BURCHAM LLMSW
Provider Business Mailing Address
First Line : 38068 LEVERETTE AVE
Second Line :
City : CLINTON TOWNSHIP
State : MI
Zip : 48038-3327
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 38271 MOUND RD STE 100
Second Line :
City : STERLING HEIGHTS
State : MI
Zip : 48310-3403
Country : US
Telephone Number : 586-913-6121
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/28/2022
Last Update Date : 07/28/2022

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