Provider Demographics
NPI:1245061878
Name:WASHINGTON-BURT, SHIRLEY A
Entity type:Individual
Prefix:
First Name:SHIRLEY
Middle Name:A
Last Name:WASHINGTON-BURT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5041 TIMBERWOOD CIR
Mailing Address - Street 2:
Mailing Address - City:ANDERSON
Mailing Address - State:IN
Mailing Address - Zip Code:46012-9731
Mailing Address - Country:US
Mailing Address - Phone:317-919-8790
Mailing Address - Fax:
Practice Address - Street 1:5041 TIMBERWOOD CIR
Practice Address - Street 2:
Practice Address - City:ANDERSON
Practice Address - State:IN
Practice Address - Zip Code:46012-9731
Practice Address - Country:US
Practice Address - Phone:317-919-8790
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-14
Last Update Date:2024-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker