Provider Demographics
NPI:1235552464
Name:BURTON, JANELL
Entity Type:Individual
Prefix:MS
First Name:JANELL
Middle Name:
Last Name:BURTON
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:JANELL
Other - Middle Name:
Other - Last Name:BURTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LADC
Mailing Address - Street 1:3049 COOL BRIDGE CIR UNIT 1
Mailing Address - Street 2:
Mailing Address - City:FORT MILL
Mailing Address - State:SC
Mailing Address - Zip Code:29715-8503
Mailing Address - Country:US
Mailing Address - Phone:857-500-0488
Mailing Address - Fax:
Practice Address - Street 1:5000 RESEARCH DRIVE
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28262
Practice Address - Country:US
Practice Address - Phone:857-500-0488
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-23
Last Update Date:2019-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional