Provider Demographics
NPI:1275120487
Name:BURKETT, MAGGIE CLAIRE (LMSW)
Entity Type:Individual
Prefix:
First Name:MAGGIE
Middle Name:CLAIRE
Last Name:BURKETT
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7015 CARVEL LN
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77074-4805
Mailing Address - Country:US
Mailing Address - Phone:281-733-5955
Mailing Address - Fax:
Practice Address - Street 1:1501 CROCKER ST APT 2
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77019-4371
Practice Address - Country:US
Practice Address - Phone:832-324-2982
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-22
Last Update Date:2020-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX17957061041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical