Doctor Name: | LISA P. BURCH |
NPI Number: | 1821151895 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LCSW |
License Number: | 105256 |
Business Practice Address: | 19 Pinney St Ellington, CT - 060293812 |
Business Phone Number: | 8608719295 |
Business Fax Number: | 8608719271 |
Mailing Address: | 19 Pinney St, ELLINGTON |
State: | CT |
Postal Code: | 060293812 |
Phone Number: | 8608719295 |
Fax Number: | 8608719271 |
NPI Enumeration Date: | 12/19/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 105256 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | MA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |