MEDICARE: KAITLIN ANN BURKE

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	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1366501173
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAITLIN ANN BURKE

Provider Business Mailing Address
First Line	:	7 HOWARD AVE
Second Line	:
City	:	PEABODY
State	:	MA
Zip	:	01960-6100
Country	:	US
Telephone Number	:	978-697-0456
Fax Number	:

Provider Business Practice Location Address
First Line	:	35 CONGRESS ST
Second Line	:	SUITE 214
City	:	SALEM
State	:	MA
Zip	:	01970-5529
Country	:	US
Telephone Number	:	978-542-1951
Fax Number	:	978-542-1954

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

Provider Enumeration Date	:	12/07/2006
Last Update Date	:	09/17/2012

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Directions to “ KAITLIN ANN BURKE ” Practice Location

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