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Individual

MR. BENJAMIN J BURKE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LPC

Contact information

Practice address
10799 N 90TH ST STE 100, SCOTTSDALE, AZ 85260-6110
(480) 804-0326
(480) 804-0083
Mailing address
1400 E SOUTHERN AVE, STE. 735, TEMPE, AZ 85282-5691
(480) 804-0326
(480) 804-0083

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
LAC-14063
AZ
101YA0400X
Addiction (Substance Use Disorder) Counselor
LASAC-13288
AZ
101YP2500X
Professional Counselor
Primary
LPC-15546
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
014628
AZ
Enumeration date
06/04/2013
Last updated
06/09/2017
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