Provider Demographics
NPI:1588961981
Name:BURK, LINNEA R (PHD)
Entity type:Individual
Prefix:DR
First Name:LINNEA
Middle Name:R
Last Name:BURK
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 259691
Mailing Address - Street 2:ACHIEVING COLLABORATIVE TREATMENT
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53725-9691
Mailing Address - Country:US
Mailing Address - Phone:608-443-7032
Mailing Address - Fax:
Practice Address - Street 1:2990 CAHILL MAIN
Practice Address - Street 2:SUITE 204
Practice Address - City:FITCHBURG
Practice Address - State:WI
Practice Address - Zip Code:53711-7130
Practice Address - Country:US
Practice Address - Phone:608-204-6083
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-02-21
Last Update Date:2011-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2647-057103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical