Provider Demographics
NPI:1669186987
Name:BURK, VIOLET LEEANN (LMSW)
Entity type:Individual
Prefix:
First Name:VIOLET
Middle Name:LEEANN
Last Name:BURK
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:VIOLET
Other - Middle Name:LEEANN
Other - Last Name:ROMMEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2995 WARRIOR LN
Mailing Address - Street 2:
Mailing Address - City:POPLAR BLUFF
Mailing Address - State:MO
Mailing Address - Zip Code:63901-8600
Mailing Address - Country:US
Mailing Address - Phone:573-712-2902
Mailing Address - Fax:
Practice Address - Street 1:2995 WARRIOR LN
Practice Address - Street 2:
Practice Address - City:POPLAR BLUFF
Practice Address - State:MO
Practice Address - Zip Code:63901-8600
Practice Address - Country:US
Practice Address - Phone:573-712-2902
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-11
Last Update Date:2024-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker