Provider Demographics
NPI:1427492008
Name:BURKE, JENNIFER (JD, LMSW)
Entity type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:
Last Name:BURKE
Suffix:
Gender:F
Credentials:JD, LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:760 WOODLAND DR
Mailing Address - Street 2:
Mailing Address - City:SALINE
Mailing Address - State:MI
Mailing Address - Zip Code:48176-1682
Mailing Address - Country:US
Mailing Address - Phone:616-204-7267
Mailing Address - Fax:
Practice Address - Street 1:760 WOODLAND DR
Practice Address - Street 2:
Practice Address - City:SALINE
Practice Address - State:MI
Practice Address - Zip Code:48176-1682
Practice Address - Country:US
Practice Address - Phone:616-204-7267
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-25
Last Update Date:2024-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010952791041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical