Provider Demographics
NPI:1851828206
Name:BURKART, MARCIE MARLOU (LCSW)
Entity Type:Individual
Prefix:
First Name:MARCIE
Middle Name:MARLOU
Last Name:BURKART
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 1:2646 KLONDIKE DR
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75228-4022
Mailing Address - Country:US
Mailing Address - Phone:817-897-5065
Mailing Address - Fax:
Practice Address - Street 1:10300 N CENTRAL EXPY STE 286
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-2258
Practice Address - Country:US
Practice Address - Phone:817-897-5065
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-16
Last Update Date:2024-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX525431041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical