Provider Demographics
NPI:1083933543
Name:BURTON, STEPHEN (LCPC)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:
Last Name:BURTON
Suffix:
Gender:M
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:67 BEECHER DR
Mailing Address - Street 2:
Mailing Address - City:RICHMOND HILL
Mailing Address - State:GA
Mailing Address - Zip Code:31324-6694
Mailing Address - Country:US
Mailing Address - Phone:240-523-3893
Mailing Address - Fax:413-683-1654
Practice Address - Street 1:67 BEECHER DR
Practice Address - Street 2:
Practice Address - City:RICHMOND HILL
Practice Address - State:GA
Practice Address - Zip Code:31324-6694
Practice Address - Country:US
Practice Address - Phone:240-523-3893
Practice Address - Fax:413-683-1654
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-24
Last Update Date:2023-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC7693101Y00000X, 101YM0800X
MDLC4994101Y00000X, 101YM0800X
GALPC007863101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101Y00000XBehavioral Health & Social Service ProvidersCounselor