Provider Demographics
NPI:1851438956
Name:BURSTON'S CONSULTING AND COUNSELING SERVICES, LLC
Entity Type:Organization
Organization Name:BURSTON'S CONSULTING AND COUNSELING SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR-OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:LUTHER
Authorized Official - Last Name:BURSTON
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:336-613-5515
Mailing Address - Street 1:PO BOX 2004
Mailing Address - Street 2:
Mailing Address - City:REIDSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27323-2004
Mailing Address - Country:US
Mailing Address - Phone:336-613-5515
Mailing Address - Fax:336-634-0449
Practice Address - Street 1:1117 S MAIN ST
Practice Address - Street 2:
Practice Address - City:REIDSVILLE
Practice Address - State:NC
Practice Address - Zip Code:27320-5313
Practice Address - Country:US
Practice Address - Phone:336-613-5515
Practice Address - Fax:336-634-0449
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC325101YA0400X
NC170103T00000X
NCC0017401041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
Not Answered103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty