Provider Demographics
NPI:1457677759
Name:BURKE, CELESTE MARY
Entity Type:Individual
Prefix:
First Name:CELESTE
Middle Name:MARY
Last Name:BURKE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:60 PERSERVERANCE WAY
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:HYANNIS
Mailing Address - State:MA
Mailing Address - Zip Code:02601-1843
Mailing Address - Country:US
Mailing Address - Phone:508-862-0273
Mailing Address - Fax:508-862-9023
Practice Address - Street 1:60 PERSERVERANCE WAY
Practice Address - Street 2:2ND FLOOR
Practice Address - City:HYANNIS
Practice Address - State:MA
Practice Address - Zip Code:02601-1843
Practice Address - Country:US
Practice Address - Phone:508-862-0273
Practice Address - Fax:508-862-9023
Is Sole Proprietor?:No
Enumeration Date:2010-04-12
Last Update Date:2010-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor