Provider Demographics
NPI:1326375163
Name:BURNSED, DYDIA ELVA (LCSW)
Entity Type:Individual
Prefix:
First Name:DYDIA
Middle Name:ELVA
Last Name:BURNSED
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 E. UNIVERSITY AVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:GEORGETOWN
Mailing Address - State:TX
Mailing Address - Zip Code:78626-7899
Mailing Address - Country:US
Mailing Address - Phone:512-686-0152
Mailing Address - Fax:
Practice Address - Street 1:2120 N MAYS ST STE 430
Practice Address - Street 2:
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78664-2108
Practice Address - Country:US
Practice Address - Phone:512-341-8905
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-16
Last Update Date:2021-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX377671041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical