Provider Demographics
NPI:1528231818
Name:S LORINNE BURKE
Entity Type:Organization
Organization Name:S LORINNE BURKE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:S
Authorized Official - Middle Name:LORINNE
Authorized Official - Last Name:BURKE
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:406-259-6161
Mailing Address - Street 1:PO BOX 80293
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59108-0293
Mailing Address - Country:US
Mailing Address - Phone:406-259-6161
Mailing Address - Fax:406-294-0967
Practice Address - Street 1:1537 AVENUE D
Practice Address - Street 2:SUITE 320
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59102-3048
Practice Address - Country:US
Practice Address - Phone:406-259-6161
Practice Address - Fax:406-294-0967
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-08
Last Update Date:2009-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT774 LCPC101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0234351Medicaid
MT740383OtherBCBS