Provider Demographics
NPI:1003100496
Name:BURGESS, LATONYA POMPEY (MSW, LMSW)
Entity type:Individual
Prefix:MS
First Name:LATONYA
Middle Name:POMPEY
Last Name:BURGESS
Suffix:
Gender:F
Credentials:MSW, LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:475 MUSEUM RD
Mailing Address - Street 2:
Mailing Address - City:ROCK HILL
Mailing Address - State:SC
Mailing Address - Zip Code:29732-8220
Mailing Address - Country:US
Mailing Address - Phone:843-356-0719
Mailing Address - Fax:
Practice Address - Street 1:475 MUSEUM RD
Practice Address - Street 2:
Practice Address - City:ROCK HILL
Practice Address - State:SC
Practice Address - Zip Code:29732-8220
Practice Address - Country:US
Practice Address - Phone:843-356-0719
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-03
Last Update Date:2024-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0060571041C0700X
253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical