Provider Demographics
NPI:1942798558
Name:BURCH, ANDREW J JR (LCSW)
Entity Type:Individual
Prefix:MR
First Name:ANDREW
Middle Name:J
Last Name:BURCH
Suffix:JR
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 1:84 COLUMBUS DR
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:08823-1734
Mailing Address - Country:US
Mailing Address - Phone:201-681-7947
Mailing Address - Fax:
Practice Address - Street 1:84 COLUMBUS DR
Practice Address - Street 2:
Practice Address - City:FRANKLIN PARK
Practice Address - State:NJ
Practice Address - Zip Code:08823-1734
Practice Address - Country:US
Practice Address - Phone:201-681-7947
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-30
Last Update Date:2018-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC055045001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical