Individual provider · Type 1 NPI

Michael Keith Burnside, LPC, LADC

Professional Counselor · Okmulgee, OK

NPI number 1194739334 Active

Practice location

100 W 7th St Ste 102
Okmulgee, OK 74447-5007

Call (918) 758-1910 Map

Fax (918) 756-1270

Mailing address

720 S 5th St
Morris, OK 74445-2224

Specialties and licenses

TaxonomyCodeLicense
Addiction (Substance Use Disorder) Counselor 101YA0400X553 (OK)
Professional Counselor Primary 101YP2500X2650 (OK)

Professional Counselor: Definition to come...

3 other providers at this address

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About NPI 1194739334

Michael Keith Burnside, LPC, LADC's National Provider Identifier is 1194739334, issued on Jul 27, 2006. The primary taxonomy on file is Professional Counselor (101YP2500X), and the practice location is in Okmulgee, OK. The record was last updated on Mar 13, 2009.