Provider Demographics
NPI:1699846295
Name:BURTON, LAURA LYNN (LMSW)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:LYNN
Last Name:BURTON
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13 MILLER ST
Mailing Address - Street 2:
Mailing Address - City:NORWICH
Mailing Address - State:NY
Mailing Address - Zip Code:13815-1309
Mailing Address - Country:US
Mailing Address - Phone:607-334-6313
Mailing Address - Fax:
Practice Address - Street 1:5 COURT ST
Practice Address - Street 2:SUITE 42, COUNTY OFFICE BUILDING
Practice Address - City:NORWICH
Practice Address - State:NY
Practice Address - Zip Code:13815-1695
Practice Address - Country:US
Practice Address - Phone:607-337-1602
Practice Address - Fax:607-334-4519
Is Sole Proprietor?:No
Enumeration Date:2006-11-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY062951-11041C0700X, 171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Not Answered171M00000XOther Service ProvidersCase Manager/Care Coordinator