Provider Demographics
NPI:1326364209
Name:BURTON, ARESSA
Entity Type:Individual
Prefix:
First Name:ARESSA
Middle Name:
Last Name:BURTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:930 CAMBRIDGE ST
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28303-9625
Mailing Address - Country:US
Mailing Address - Phone:910-294-5915
Mailing Address - Fax:267-392-7600
Practice Address - Street 1:930 CAMBRIDGE ST
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28303-9625
Practice Address - Country:US
Practice Address - Phone:910-723-3245
Practice Address - Fax:267-392-7600
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-16
Last Update Date:2018-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
552933OtherMHN