Provider Demographics
NPI:1023545399
Name:BUERKLE, GRETA C (LCSW)
Entity Type:Individual
Prefix:
First Name:GRETA
Middle Name:C
Last Name:BUERKLE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36 2ND ST UNIT 1
Mailing Address - Street 2:
Mailing Address - City:KEYPORT
Mailing Address - State:NJ
Mailing Address - Zip Code:07735-1506
Mailing Address - Country:US
Mailing Address - Phone:917-721-7347
Mailing Address - Fax:
Practice Address - Street 1:36 2ND ST UNIT 1
Practice Address - Street 2:
Practice Address - City:KEYPORT
Practice Address - State:NJ
Practice Address - Zip Code:07735-1506
Practice Address - Country:US
Practice Address - Phone:917-721-7347
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-17
Last Update Date:2022-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC061273001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical