Provider Demographics
NPI:1558402719
Name:BURKAMP, ANDREW WALTER (MA, CADC I)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:WALTER
Last Name:BURKAMP
Suffix:
Gender:M
Credentials:MA, CADC I
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2644 SE 50TH AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97206-1536
Mailing Address - Country:US
Mailing Address - Phone:503-313-1669
Mailing Address - Fax:
Practice Address - Street 1:19 WATER ST
Practice Address - Street 2:
Practice Address - City:SOUTH GLASTONBURY
Practice Address - State:CT
Practice Address - Zip Code:06073-2225
Practice Address - Country:US
Practice Address - Phone:503-535-1150
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-09
Last Update Date:2016-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist