Provider Demographics
NPI:1447306279
Name:BURKE-LEWIS, KARIN M
Entity type:Individual
Prefix:MS
First Name:KARIN
Middle Name:M
Last Name:BURKE-LEWIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 HAMILTON AVE
Mailing Address - Street 2:
Mailing Address - City:QUINCY
Mailing Address - State:MA
Mailing Address - Zip Code:02171-2811
Mailing Address - Country:US
Mailing Address - Phone:617-457-8140
Mailing Address - Fax:617-457-8141
Practice Address - Street 1:130 BOYLSTON ST
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02116-4608
Practice Address - Country:US
Practice Address - Phone:617-457-8140
Practice Address - Fax:617-457-8141
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1110691041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical