Individual
CASEY BURGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
24077 STATE HIGHWAY 49, NEVADA CITY, CA 95959-8519
(530) 265-9057
Mailing address
24077 STATE HIGHWAY 49, NEVADA CITY, CA 95959-8519
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
1386091007
CA
101YM0800X
Mental Health Counselor
—
—
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
05/23/2016
Last updated
02/22/2017
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