Provider Demographics
NPI:1063534378
Name:BURKE, MICHELLE C (MS, MLADC)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:C
Last Name:BURKE
Suffix:
Gender:F
Credentials:MS, MLADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:368 RIVER ST.
Mailing Address - Street 2:#160
Mailing Address - City:SPRINGFIELD
Mailing Address - State:VT
Mailing Address - Zip Code:05156
Mailing Address - Country:US
Mailing Address - Phone:802-231-4486
Mailing Address - Fax:802-541-1299
Practice Address - Street 1:368 RIVER ST.
Practice Address - Street 2:#160
Practice Address - City:SPRINGFIELD
Practice Address - State:VT
Practice Address - Zip Code:05156
Practice Address - Country:US
Practice Address - Phone:802-231-4486
Practice Address - Fax:802-541-1299
Is Sole Proprietor?:No
Enumeration Date:2007-04-06
Last Update Date:2024-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)