Burkett, Martha Doran
Burkett, Martha Doran is an sole proprietor health care provider with primary practice located at 2424 Burton St Se Ste 104 , Grand Rapids MI 49546-4833. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Professional. Behavioral Health & Social Service Providers / Professional is her primary health care specialty. Burkett, Martha Doran can be contacted via phone (616) 541-4211.Contact Information
Primary practice address
2424 Burton St Se Ste 104
Grand Rapids MI 49546-4833
Phone: (616) 541-4211
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) | 101YA0400X | C-00076 | Michigan |
| Behavioral Health & Social Service Providers / Professional | 101YP2500X | 6401009140 | Michigan |
Profile Details
| NPI number | 1689856627 |
|---|---|
| LBN Legal business name | Burkett, Martha Doran |
| Credentials | LPC, NCC, CAADC,ADS |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Dec 1st, 2007 |
| Last updated | Aug 27th, 2019 - about 6 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1689856627 | NPPES |
| Michigan | Other | 6401009140 | COUNSELING LICENSE |
| Michigan | Other | 5797 | COUNSELING LICENSE |
| Michigan | Other | 11806665 | COUNSELING LICENSE |
| Michigan | Other | 95289 | COUNSELING LICENSE |
| Michigan | Other | C-00076 | COUNSELING LICENSE |
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