Burks, Carol Jean
Burks, Carol Jean is an sole proprietor health care provider with primary practice located at 2301 Riverside Dr Suite 8, Green Bay WI 54301-1907. She recently has only one registered license in Behavioral Health & Social Service Providers / Professional, which is considered as her primary health care specialty. Burks, Carol Jean can be contacted via phone (920) 430-9100.Contact Information
Primary practice address
2301 Riverside Dr Suite 8
Green Bay WI 54301-1907
Phone: (920) 430-9100
Fax: (920) 430-9101
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Professional | 101YP2500X | 2997-125 | Wisconsin |
Profile Details
| NPI number | 1316070022 |
|---|---|
| LBN Legal business name | Burks, Carol Jean |
| Credentials | MS, LPC |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Mar 13th, 2007 |
| Last updated | Jul 8th, 2007 - about 17 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 | 1316070022 | NPPES |
| Wisconsin | MEDICAID | 43583600 |
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