Provider Demographics
NPI:1497390975
Name:BURKE, CHRISTIE (LMSW)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTIE
Middle Name:
Last Name:BURKE
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 1:48 YACHT CLUB RD
Mailing Address - Street 2:
Mailing Address - City:BABYLON
Mailing Address - State:NY
Mailing Address - Zip Code:11702-4518
Mailing Address - Country:US
Mailing Address - Phone:631-258-4699
Mailing Address - Fax:
Practice Address - Street 1:325 SUNRISE HWY
Practice Address - Street 2:
Practice Address - City:WEST ISLIP
Practice Address - State:NY
Practice Address - Zip Code:11795-2110
Practice Address - Country:US
Practice Address - Phone:631-472-2629
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-08
Last Update Date:2019-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY097581104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker