Michael Keith Burnside, LPC, LADC

NPI #1194739334 in Okmulgee, Oklahoma

Provider Information

NPI Number: 1194739334
Entity Type: Individual
Name: Michael Keith Burnside, LPC, LADC
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Counselor - Professional
Credential: LPC, LADC
Enumeration Date: Jul 27, 2006
Last Updated: Mar 13, 2009

Practice Location

Address: 100 W 7TH ST STE 102
City: Okmulgee
State: Oklahoma
ZIP Code: 74447-5007
Phone: (918) 758-1910

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor - Addiction (Substance Use Disorder) — Addiction (Substance Use Disorder)	101YA0400X
Counselor - Professional — Professional	101YP2500X	Primary

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