Provider Demographics
NPI:1972973873
Name:BURTON, SHAWN RICHARD (LPC)
Entity Type:Individual
Prefix:
First Name:SHAWN
Middle Name:RICHARD
Last Name:BURTON
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20525 CENTER RIDGE RD
Mailing Address - Street 2:STE 365
Mailing Address - City:ROCKY RIVER
Mailing Address - State:OH
Mailing Address - Zip Code:44116-3437
Mailing Address - Country:US
Mailing Address - Phone:866-466-9591
Mailing Address - Fax:216-712-6313
Practice Address - Street 1:20525 CENTER RIDGE RD
Practice Address - Street 2:STE 365
Practice Address - City:ROCKY RIVER
Practice Address - State:OH
Practice Address - Zip Code:44116-3437
Practice Address - Country:US
Practice Address - Phone:866-466-9591
Practice Address - Fax:216-712-6313
Is Sole Proprietor?:No
Enumeration Date:2015-10-05
Last Update Date:2015-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC1100345101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional