Provider Demographics
NPI:1689276446
Name:BURKE, MARIE F (LCSW)
Entity Type:Individual
Prefix:
First Name:MARIE
Middle Name:F
Last Name:BURKE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 MECHANIC ST STE 302
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01608-2419
Mailing Address - Country:US
Mailing Address - Phone:508-792-5400
Mailing Address - Fax:508-831-0074
Practice Address - Street 1:861 MAIN ST
Practice Address - Street 2:
Practice Address - City:WEYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02190-1658
Practice Address - Country:US
Practice Address - Phone:781-331-3709
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-16
Last Update Date:2020-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA203504104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker