Provider Demographics
NPI:1447553557
Name:BURCLAW, JOSEPH C (LPC)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:C
Last Name:BURCLAW
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:279 ROSS AVE
Mailing Address - Street 2:
Mailing Address - City:SCHOFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:54476-1869
Mailing Address - Country:US
Mailing Address - Phone:157-496-6273
Mailing Address - Fax:715-650-9136
Practice Address - Street 1:279 ROSS AVE
Practice Address - Street 2:
Practice Address - City:SCHOFIELD
Practice Address - State:WI
Practice Address - Zip Code:54476-1869
Practice Address - Country:US
Practice Address - Phone:157-496-6273
Practice Address - Fax:715-650-9136
Is Sole Proprietor?:No
Enumeration Date:2010-12-10
Last Update Date:2024-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI7691125101YP2500X
WI15785101YA0400X
WI3671-226101YA0400X
WI7691104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI15785-131OtherSTATE LICENSE