Provider Demographics
NPI:1831214709
Name:BURKS, ARIC E (LPC)
Entity type:Individual
Prefix:
First Name:ARIC
Middle Name:E
Last Name:BURKS
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2029 S 17TH ST
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28401-6600
Mailing Address - Country:US
Mailing Address - Phone:910-798-6587
Mailing Address - Fax:910-798-6643
Practice Address - Street 1:401 S 10TH ST
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28401-5315
Practice Address - Country:US
Practice Address - Phone:910-815-6906
Practice Address - Fax:910-772-7805
Is Sole Proprietor?:No
Enumeration Date:2007-03-20
Last Update Date:2010-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCLPC-2245101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6102725Medicaid
NC1347ROtherBCBS