Provider Demographics
NPI:1821475187
Name:WJ BURTON LLC
Entity Type:Organization
Organization Name:WJ BURTON LLC
Other - Org Name:BURTON COUNSELING LLC
Other - Org Type:Other Name
Authorized Official - Title/Position:CLINICAL SOCIAL WORKER
Authorized Official - Prefix:
Authorized Official - First Name:WANITA
Authorized Official - Middle Name:JANE
Authorized Official - Last Name:BURTON
Authorized Official - Suffix:
Authorized Official - Credentials:LISW-S
Authorized Official - Phone:740-687-0900
Mailing Address - Street 1:1611 TIKI LANE
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:OH
Mailing Address - Zip Code:43130-8729
Mailing Address - Country:US
Mailing Address - Phone:740-687-0900
Mailing Address - Fax:740-689-2725
Practice Address - Street 1:117 W MAIN ST STE 106
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:OH
Practice Address - Zip Code:43130-3722
Practice Address - Country:US
Practice Address - Phone:740-687-0900
Practice Address - Fax:740-689-2725
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-06
Last Update Date:2023-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI00040841041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty