Provider Demographics
NPI:1760795124
Name:BURZINSKI-GORFINKEL, AMY N (LISW)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:N
Last Name:BURZINSKI-GORFINKEL
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:N
Other - Last Name:BURZINSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3659 GREEN RD
Mailing Address - Street 2:STE 222
Mailing Address - City:BEACHWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44122-5727
Mailing Address - Country:US
Mailing Address - Phone:216-570-1597
Mailing Address - Fax:216-834-0014
Practice Address - Street 1:3659 GREEN RD
Practice Address - Street 2:STE 222
Practice Address - City:BEACHWOOD
Practice Address - State:OH
Practice Address - Zip Code:44122-5727
Practice Address - Country:US
Practice Address - Phone:216-570-1597
Practice Address - Fax:216-834-0014
Is Sole Proprietor?:No
Enumeration Date:2010-07-14
Last Update Date:2010-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI.0009115104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker