Burke Behavioral Health, LLC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

071007221 Issued in IL

Legal business name

BURKE BEHAVIORAL HEALTH, LLC

Practice address

3200 Fishback Rd
Carbondale, IL 62901-6307

Phone

(618) 527-6144

Fax

(618) 529-1693

NPI assigned

Jan 23, 2008

Last updated

Apr 22, 2010By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Philip A Burke, PH.D.

Title

Sole Member

Phone

(618) 527-6144

Specialties & licenses 1

Addresses

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Melinda Luanne Bloos, PH.D.

  • Clinical Psychologist
  • Murphysboro, IL
  • NPI 1437247012
  NPD (past)
• Frank Xavier Kosmicki, PH.D.

  • Psychologist
  • Carbondale, IL
  • NPI 1619077203
  NPD (past)
• Gail Peterson, PH.D.

  • Cognitive & Behavioral Psychologist
  • Murphysboro, IL
  • NPI 1629058904
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1201046400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1271894400000",
    "number": "1972780880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1442",
            "city": "CARBONDALE",
            "state": "IL",
            "postal_code": "629031442",
            "telephone_number": "618-527-6144",
            "fax_number": "618-529-1693"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 FISHBACK RD",
            "city": "CARBONDALE",
            "state": "IL",
            "postal_code": "629016307",
            "telephone_number": "618-527-6144",
            "fax_number": "618-529-1693"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BURKE BEHAVIORAL HEALTH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-23",
        "last_updated": "2010-04-22",
        "status": "A",
        "authorized_official_last_name": "BURKE",
        "authorized_official_first_name": "PHILIP",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "SOLE MEMBER",
        "authorized_official_telephone_number": "618-527-6144",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071007221",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tamara Buckles, MD
• F Dale Budslick, LCPC
• Seif Bugazia, MD
• Sarah M. D. Buila, MSW, LCSW, PH.D.
• Ahmed Bukhamsin, BS
• Sharon Saum Burruss, O.D.
• Monica Burtley-Miller, LCSW
• Jonathan W Burton, D.M.D.
• Warren Thomas Bush, PH.D.
• Kelly A Bushur, CP PH.D

• Clinical Psychologist in Carbondale, IL
• Providers in Carbondale, IL by specialty
• Clinical Psychologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.