Provider Demographics
NPI:1518411735
Name:BURR, TAMARA BONCIA (LCSW)
Entity Type:Individual
Prefix:
First Name:TAMARA
Middle Name:BONCIA
Last Name:BURR
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 1:845 OVERLOOK CIR
Mailing Address - Street 2:
Mailing Address - City:HUEYTOWN
Mailing Address - State:AL
Mailing Address - Zip Code:35023-1619
Mailing Address - Country:US
Mailing Address - Phone:205-777-1716
Mailing Address - Fax:
Practice Address - Street 1:845 OVERLOOK CIR
Practice Address - Street 2:
Practice Address - City:HUEYTOWN
Practice Address - State:AL
Practice Address - Zip Code:35023-1619
Practice Address - Country:US
Practice Address - Phone:205-777-1716
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-04
Last Update Date:2016-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL3674C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical