MEDICARE: DEBURGH BURKED

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	101YM0800X	Mental Health Counselor
2	101YS0200X	School Counselor
3	101YP1600X	Pastoral Counselor

General Provider Information

NPI Number	:	1447942248
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DEBURGH BURKED

Provider Business Mailing Address
First Line	:	6595 ROSWELL RD
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30328-3152
Country	:	US
Telephone Number	:	844-244-2199
Fax Number	:

Provider Business Practice Location Address
First Line	:	400 W PEACHTREE ST NW
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30308-3536
Country	:	US
Telephone Number	:	844-244-2199
Fax Number	:

Authorized Official
Title or Position	:	CHIEF OPERATING OFFCER
Name	:	PATRICIA TURNER
Credential	:
Telephone Number	:	844-244-2199

Provider Enumeration Date	:	05/22/2023
Last Update Date	:	05/24/2023

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Directions to “DEBURGH BURKED ” Practice Location

Language	Start Address	Practice Location

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