Provider Demographics
NPI:1356340095
Name:BURTON, BARBARA (LCSW)
Entity type:Individual
Prefix:MS
First Name:BARBARA
Middle Name:
Last Name:BURTON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9374 OLIVE BLVD
Mailing Address - Street 2:SUITE 202
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63132-3253
Mailing Address - Country:US
Mailing Address - Phone:314-997-5900
Mailing Address - Fax:314-997-5900
Practice Address - Street 1:9374 OLIVE BLVD
Practice Address - Street 2:SUITE 202
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63132-3253
Practice Address - Country:US
Practice Address - Phone:314-997-5900
Practice Address - Fax:314-997-5900
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-15
Last Update Date:2009-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO0013461041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO260145OtherMHN
MO10849354OtherCAQH
MO000014909Medicare PIN