Provider Demographics
NPI:1528430378
Name:BUREK, KATHERINE (ADC-T)
Entity type:Individual
Prefix:MS
First Name:KATHERINE
Middle Name:
Last Name:BUREK
Suffix:
Gender:F
Credentials:ADC-T
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6550 YORK AVE S
Mailing Address - Street 2:STE 620
Mailing Address - City:EDINA
Mailing Address - State:MN
Mailing Address - Zip Code:55435-2347
Mailing Address - Country:US
Mailing Address - Phone:952-926-2526
Mailing Address - Fax:952-926-6791
Practice Address - Street 1:6550 YORK AVE S
Practice Address - Street 2:STE 620
Practice Address - City:EDINA
Practice Address - State:MN
Practice Address - Zip Code:55435-2347
Practice Address - Country:US
Practice Address - Phone:952-926-2526
Practice Address - Fax:952-926-6791
Is Sole Proprietor?:No
Enumeration Date:2015-10-20
Last Update Date:2015-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)