Provider Demographics
NPI:1679444228
Name:BURKE, DENNIS (CAC, ICADC, CRPS)
Entity type:Individual
Prefix:
First Name:DENNIS
Middle Name:
Last Name:BURKE
Suffix:
Gender:M
Credentials:CAC, ICADC, CRPS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3185 BOUTWELL RD
Mailing Address - Street 2:
Mailing Address - City:LAKE WORTH BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33461-2610
Mailing Address - Country:US
Mailing Address - Phone:561-621-2517
Mailing Address - Fax:
Practice Address - Street 1:3185 BOUTWELL RD
Practice Address - Street 2:
Practice Address - City:LAKE WORTH BEACH
Practice Address - State:FL
Practice Address - Zip Code:33461-2610
Practice Address - Country:US
Practice Address - Phone:561-621-2517
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-16
Last Update Date:2025-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCAC.013473101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty