Provider Demographics
NPI:1265272504
Name:BURKE, BELINDA KAY (LRC, CHW)
Entity type:Individual
Prefix:
First Name:BELINDA
Middle Name:KAY
Last Name:BURKE
Suffix:
Gender:F
Credentials:LRC, CHW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1410 N TONOPAH DR
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89106-1961
Mailing Address - Country:US
Mailing Address - Phone:985-314-5222
Mailing Address - Fax:
Practice Address - Street 1:1410 N TONOPAH DR
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89106-1961
Practice Address - Country:US
Practice Address - Phone:985-314-5222
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-24
Last Update Date:2024-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health