Provider Demographics
NPI:1003692823
Name:BURKE, MAIREAD (LCSW-C)
Entity type:Individual
Prefix:MS
First Name:MAIREAD
Middle Name:
Last Name:BURKE
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 8313
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20907-8313
Mailing Address - Country:US
Mailing Address - Phone:240-203-9303
Mailing Address - Fax:240-244-9980
Practice Address - Street 1:9507 DALLAS AVE
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20901-3213
Practice Address - Country:US
Practice Address - Phone:240-203-9303
Practice Address - Fax:240-244-9980
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-06
Last Update Date:2023-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD233671041C0700X
TX595121041C0700X
DCLC500821181041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical