Provider Demographics
NPI:1457944159
Name:BURT, YONZEL (EDD; LCSW; CCTP)
Entity Type:Individual
Prefix:DR
First Name:YONZEL
Middle Name:
Last Name:BURT
Suffix:
Gender:F
Credentials:EDD; LCSW; CCTP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:48 PETTOM RD
Mailing Address - Street 2:
Mailing Address - City:NORWALK
Mailing Address - State:CT
Mailing Address - Zip Code:06850-3111
Mailing Address - Country:US
Mailing Address - Phone:203-974-9050
Mailing Address - Fax:
Practice Address - Street 1:48 PETTOM RD
Practice Address - Street 2:
Practice Address - City:NORWALK
Practice Address - State:CT
Practice Address - Zip Code:06850-3111
Practice Address - Country:US
Practice Address - Phone:203-974-9050
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-15
Last Update Date:2023-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT135281041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty