Provider Demographics
NPI:1104617661
Name:BURK, JOHN JR (MSW)
Entity type:Individual
Prefix:MR
First Name:JOHN
Middle Name:
Last Name:BURK
Suffix:JR
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 NORTHWOOD DR
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47872-1234
Mailing Address - Country:US
Mailing Address - Phone:812-605-9418
Mailing Address - Fax:
Practice Address - Street 1:5 S WALNUT ST
Practice Address - Street 2:
Practice Address - City:BRAZIL
Practice Address - State:IN
Practice Address - Zip Code:47834-2620
Practice Address - Country:US
Practice Address - Phone:812-605-9418
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-14
Last Update Date:2025-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool