Provider Demographics
NPI:1710149729
Name:BURGESS, THELMA ELIZABETH (MSW, LCSW, LCAS-A, C)
Entity Type:Individual
Prefix:MRS
First Name:THELMA
Middle Name:ELIZABETH
Last Name:BURGESS
Suffix:
Gender:F
Credentials:MSW, LCSW, LCAS-A, C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 OLDE COVINGTON WAY
Mailing Address - Street 2:
Mailing Address - City:ARDEN
Mailing Address - State:NC
Mailing Address - Zip Code:28704-9336
Mailing Address - Country:US
Mailing Address - Phone:828-702-6772
Mailing Address - Fax:828-210-1404
Practice Address - Street 1:ONE OAK PLAZA
Practice Address - Street 2:SUITE 208
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28801
Practice Address - Country:US
Practice Address - Phone:828-575-9760
Practice Address - Fax:828-210-1404
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-30
Last Update Date:2020-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCLCAS23202101YA0400X
NCC0060721041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)