Brian Jay Burgener, LCSW

Individual provider Active NPI Clinical Social Worker · Burke, VA

NPI 1174780191 · NPPES record last updated May 19, 2008

Key facts

NPI
1174780191
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
SC 10076 (NJ)
Practice address
9403 Odyssey CT
Burke, VA 22015-1910
Phone
(703) 426-0499
NPI assigned
May 19, 2008
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
SC 10076NJMDClinical Social Worker

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X SC 10076 NJ Yes

Addresses

Primary practice location

9403 Odyssey CT
Burke, VA 22015-1910

Mailing address

9403 Odyssey CT
Burke, VA 22015-1910
Phone (703) 426-0499

Other providers in Burke, VA

All providers in Burke, VA · Clinical Social Worker in Virginia

Sources for this page

Verify at the official NPI Registry.