Provider Demographics
NPI:1972386332
Name:BURKE, CATHERINE CRANFORD (MS)
Entity Type:Individual
Prefix:
First Name:CATHERINE CRANFORD
Middle Name:
Last Name:BURKE
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:CRANFORD
Other - Middle Name:
Other - Last Name:BURKE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MS
Mailing Address - Street 1:404 ONEIDA ST
Mailing Address - Street 2:
Mailing Address - City:GRAHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27253-2231
Mailing Address - Country:US
Mailing Address - Phone:803-269-7451
Mailing Address - Fax:
Practice Address - Street 1:107 GRAY DRIVE
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27412-5034
Practice Address - Country:US
Practice Address - Phone:336-334-3543
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-17
Last Update Date:2023-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA19014101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health