Individual
GWENDOLYN D BURKE
Active
Individual
GWENDOLYN D BURKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW, LSCSW
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
2003003710
MO
1041C0700X
Clinical Social Worker
2291
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
35268043
BCBSKC PPO
MO
01
—
35405
COMMCARE
MO
05
—
499357002
—
MO
05
—
499357010
—
MO
05
—
499357028
—
MO
01
—
7736772
AETNA
MO
01
—
9369366
PHCS
MO
01
—
C16D620
MEDICARE B WHEATLANDS
MO
Enumeration date
06/04/2006
Last updated
01/18/2008
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