Provider Demographics
NPI:1851567176
Name:BURRIS, CHRIS H (LPC, LMFT)
Entity Type:Individual
Prefix:MR
First Name:CHRIS
Middle Name:H
Last Name:BURRIS
Suffix:
Gender:M
Credentials:LPC, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:610 FRIAR TUCK RD
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27104-1615
Mailing Address - Country:US
Mailing Address - Phone:336-816-7353
Mailing Address - Fax:336-722-9608
Practice Address - Street 1:610 FRIAR TUCK RD
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27104-1615
Practice Address - Country:US
Practice Address - Phone:336-816-7353
Practice Address - Fax:336-722-9608
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-06
Last Update Date:2009-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2781101YP2500X
NC709106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional