Provider Demographics
NPI:1457596884
Name:MCCLERKLIN, BURTON (COUNSELOR)
Entity Type:Individual
Prefix:
First Name:BURTON
Middle Name:
Last Name:MCCLERKLIN
Suffix:
Gender:M
Credentials:COUNSELOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:191 SANDS ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11201-1588
Mailing Address - Country:US
Mailing Address - Phone:917-499-8027
Mailing Address - Fax:
Practice Address - Street 1:191 SANDS ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11201-1588
Practice Address - Country:US
Practice Address - Phone:917-499-8027
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-12-15
Last Update Date:2008-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)