Individual
NAOMI ALIXANDRA NICHELLE BURKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW, LCADC
Contact information
Practice address
210 N BROADWAY ST STE 1, BEREA, KY 40403-2212
(859) 267-7141
Mailing address
108 LORRAINE CT, BEREA, KY 40403-1318
(859) 267-7141
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
279096
KY
1041C0700X
Clinical Social Worker
254909
KY
1041C0700X
Clinical Social Worker
Primary
257296
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100782040
—
KY
Enumeration date
09/30/2021
Last updated
08/28/2023
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