Provider Demographics
NPI:1265077127
Name:BOBBI J BURG LCSW LLC
Entity type:Organization
Organization Name:BOBBI J BURG LCSW LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BOBBI
Authorized Official - Middle Name:J
Authorized Official - Last Name:BURG
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:816-702-8778
Mailing Address - Street 1:305 SW MARKET ST # 8
Mailing Address - Street 2:
Mailing Address - City:LEES SUMMIT
Mailing Address - State:MO
Mailing Address - Zip Code:64063-2388
Mailing Address - Country:US
Mailing Address - Phone:816-702-8778
Mailing Address - Fax:816-203-4499
Practice Address - Street 1:305 SW MARKET ST # 8
Practice Address - Street 2:
Practice Address - City:LEES SUMMIT
Practice Address - State:MO
Practice Address - Zip Code:64063-2388
Practice Address - Country:US
Practice Address - Phone:816-702-8778
Practice Address - Fax:816-203-4499
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-14
Last Update Date:2021-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty