Individual
MR. BLAINE G. BURKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
L.M.S.W.,CAAC
Contact information
Practice address
311 E MARKET ST STE 3, LIMA, OH 45801-4535
(419) 222-4474
(419) 222-7044
Mailing address
19323 ARDMORE ST, DETROIT, MI 48235-1704
(313) 585-2242
(313) 397-1547
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
6801064874
MI
1041C0700X
Clinical Social Worker
I.2304497
OH
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
08/30/2006
Last updated
02/05/2026
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