Provider Demographics
NPI:1700866878
Name:BURKE, DARLENE C (LCSW)
Entity Type:Individual
Prefix:MS
First Name:DARLENE
Middle Name:C
Last Name:BURKE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1357 KINGS HIGHWAY, PO BOX 5
Mailing Address - Street 2:
Mailing Address - City:SUGAR LOAF
Mailing Address - State:NY
Mailing Address - Zip Code:10981-0005
Mailing Address - Country:US
Mailing Address - Phone:845-469-6266
Mailing Address - Fax:845-469-6266
Practice Address - Street 1:1357 KINGS HIGHWAY
Practice Address - Street 2:
Practice Address - City:SUGAR LOAF
Practice Address - State:NY
Practice Address - Zip Code:10981-0005
Practice Address - Country:US
Practice Address - Phone:845-469-6266
Practice Address - Fax:845-469-6266
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-17
Last Update Date:2024-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ445C054061001041C0700X
NYR0365311041C0700X
NYR036531-011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02025845Medicaid
NYN60011Medicare ID - Type Unspecified