Provider Demographics
NPI:1043501737
Name:BURKE, ELSA CARLINE (MSW)
Entity type:Individual
Prefix:MS
First Name:ELSA
Middle Name:CARLINE
Last Name:BURKE
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:121 N 2ND ST
Mailing Address - Street 2:SUITE 301
Mailing Address - City:FORT PIERCE
Mailing Address - State:FL
Mailing Address - Zip Code:34950-4435
Mailing Address - Country:US
Mailing Address - Phone:772-595-3773
Mailing Address - Fax:
Practice Address - Street 1:6191 HONEYWOOD WAY
Practice Address - Street 2:BRENTWOOD LAKES
Practice Address - City:LAKE WORTH
Practice Address - State:FL
Practice Address - Zip Code:33463-6737
Practice Address - Country:US
Practice Address - Phone:561-396-7240
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-28
Last Update Date:2011-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health