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MR. ROY NMI BURKES CADC

Addiction Substance Use Disorder

Iowa City, Iowa

Provider NPI: 1871518720

Provider Information:
MR. ROY NMI BURKES CADC
Gender: M
Sole Proprietor


Practice Location:
601 HIGHWAY 6 W  IOWA CITY, IA 52246 US
Tel: 319-338-0581  Fax: --

Business Mailing Address:
2203 1/2 MUSCATINE AVE APT A  IOWA CITY, IA 52240 US
Tel: 319-512-1634  Fax: --

Entity Type: Individual

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
Y101YA0400XBehavioral Health & Social Service Providers
Counselor
Addiction (Substance Use Disorder)
IL15076

Other Provider Identifiers:

IssuerNumberStateType
IAODAPCA - CERTIFICATION15076IL01
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin







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