Provider Demographics
NPI:1538310008
Name:JARRARD, ANITA BURLESON (MSW, P-LCSW)
Entity Type:Individual
Prefix:MS
First Name:ANITA
Middle Name:BURLESON
Last Name:JARRARD
Suffix:
Gender:F
Credentials:MSW, P-LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 WEBSTER DR N
Mailing Address - Street 2:
Mailing Address - City:WILSON
Mailing Address - State:NC
Mailing Address - Zip Code:27893-1754
Mailing Address - Country:US
Mailing Address - Phone:252-289-7219
Mailing Address - Fax:
Practice Address - Street 1:7907 BUCK DEANS RD
Practice Address - Street 2:
Practice Address - City:MIDDLESEX
Practice Address - State:NC
Practice Address - Zip Code:27557-9380
Practice Address - Country:US
Practice Address - Phone:252-235-2161
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-02
Last Update Date:2008-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0040731041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical