Provider Demographics
NPI:1770263337
Name:BURKHALTER, CHEMIKA (LCSW)
Entity type:Individual
Prefix:
First Name:CHEMIKA
Middle Name:
Last Name:BURKHALTER
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 1:12734 SW 204TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33177-5113
Mailing Address - Country:US
Mailing Address - Phone:786-584-0322
Mailing Address - Fax:
Practice Address - Street 1:12734 SW 204TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33177-5113
Practice Address - Country:US
Practice Address - Phone:786-584-0322
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-19
Last Update Date:2023-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW137311041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical