Provider Demographics
NPI:1679238224
Name:SCHARFENBERG-BURFORD, CATHRYN
Entity Type:Individual
Prefix:
First Name:CATHRYN
Middle Name:
Last Name:SCHARFENBERG-BURFORD
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 1:1515 S MOJAVE RD SPC 2
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89104-4530
Mailing Address - Country:US
Mailing Address - Phone:702-540-0769
Mailing Address - Fax:
Practice Address - Street 1:3852 PALOS VERDES ST
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89119-6909
Practice Address - Country:US
Practice Address - Phone:702-540-0769
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-08
Last Update Date:2021-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YA0400X
NV06962-I101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)