Provider Demographics
NPI:1831595867
Name:BURTON, DAWN DEMETRIS (MSW, LCSW-A)
Entity type:Individual
Prefix:
First Name:DAWN
Middle Name:DEMETRIS
Last Name:BURTON
Suffix:
Gender:F
Credentials:MSW, LCSW-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:121 HUNT ST
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27701-2411
Mailing Address - Country:US
Mailing Address - Phone:252-343-7926
Mailing Address - Fax:
Practice Address - Street 1:3503 N MAIN ST
Practice Address - Street 2:
Practice Address - City:TARBORO
Practice Address - State:NC
Practice Address - Zip Code:27886-1733
Practice Address - Country:US
Practice Address - Phone:252-823-8448
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-11-19
Last Update Date:2014-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0088231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical