Individual
DR. LEO JOSEPH BURKE III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSY.D., P.C.
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
PC004513
PA
101YP2500X
Professional Counselor
PC004513
PA
103TC0700X
Clinical Psychologist
1375
LA
103TC0700X
Clinical Psychologist
PS017349
PA
103TC2200X
Clinical Child & Adolescent Psychologist
PS017349
PA
103TP0016X
Prescribing (Medical) Psychologist
Primary
304056
LA
Other
Enumeration date
09/06/2007
Last updated
09/19/2019
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