Provider Demographics
NPI:1245837350
Name:BURKS, BRETT
Entity type:Individual
Prefix:
First Name:BRETT
Middle Name:
Last Name:BURKS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:141 W DODSON
Mailing Address - Street 2:
Mailing Address - City:CADDO VALLEY
Mailing Address - State:AR
Mailing Address - Zip Code:71923-9605
Mailing Address - Country:US
Mailing Address - Phone:501-428-2669
Mailing Address - Fax:
Practice Address - Street 1:1420 S MAIN ST
Practice Address - Street 2:
Practice Address - City:HOPE
Practice Address - State:AR
Practice Address - Zip Code:71801-7243
Practice Address - Country:US
Practice Address - Phone:870-777-4848
Practice Address - Fax:870-777-2410
Is Sole Proprietor?:No
Enumeration Date:2020-10-02
Last Update Date:2025-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No171M00000XOther Service ProvidersCase Manager/Care Coordinator