Provider Demographics
NPI:1225472905
Name:BURTON, TAMELA L (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:TAMELA
Middle Name:L
Last Name:BURTON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:TAMELA
Other - Middle Name:L
Other - Last Name:SEATON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LSW
Mailing Address - Street 1:PO BOX 550769
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77255-0769
Mailing Address - Country:US
Mailing Address - Phone:713-686-9194
Mailing Address - Fax:
Practice Address - Street 1:300 E RANDOLPH ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60601-5014
Practice Address - Country:US
Practice Address - Phone:312-972-3083
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-24
Last Update Date:2018-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX652651041C0700X
IL1490189431041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty