Provider Demographics
NPI:1710692710
Name:BURKS, ALEXANDER J (LCSW)
Entity Type:Individual
Prefix:
First Name:ALEXANDER
Middle Name:J
Last Name:BURKS
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5745 PECAN CT
Mailing Address - Street 2:
Mailing Address - City:NOBLESVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46062-1205
Mailing Address - Country:US
Mailing Address - Phone:317-992-1914
Mailing Address - Fax:
Practice Address - Street 1:8520 ALLISON POINTE BLVD STE 220
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46250-4299
Practice Address - Country:US
Practice Address - Phone:317-758-8547
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-16
Last Update Date:2024-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1041C0700X
IN34010899A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical