Provider Demographics
NPI:1417643362
Name:BURKS, ABIGAIL EVE (LMSW)
Entity Type:Individual
Prefix:MRS
First Name:ABIGAIL
Middle Name:EVE
Last Name:BURKS
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:ABIGAIL
Other - Middle Name:EVE
Other - Last Name:BICKMORE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:408 LONGLEAF DR
Mailing Address - Street 2:
Mailing Address - City:SLIDELL
Mailing Address - State:LA
Mailing Address - Zip Code:70458-1711
Mailing Address - Country:US
Mailing Address - Phone:801-898-2673
Mailing Address - Fax:
Practice Address - Street 1:201 GREENBRIER BLVD
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:LA
Practice Address - Zip Code:70433-7236
Practice Address - Country:US
Practice Address - Phone:985-893-2970
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-13
Last Update Date:2023-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA169801104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker