Provider Demographics
NPI:1982974457
Name:BURRUSS, CHARLITTA ESTIE (SOCIAL WORKER)
Entity Type:Individual
Prefix:MS
First Name:CHARLITTA
Middle Name:ESTIE
Last Name:BURRUSS
Suffix:
Gender:F
Credentials:SOCIAL WORKER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 538
Mailing Address - Street 2:
Mailing Address - City:WADESBORO
Mailing Address - State:NC
Mailing Address - Zip Code:28170
Mailing Address - Country:US
Mailing Address - Phone:704-904-9674
Mailing Address - Fax:
Practice Address - Street 1:323 E PHIFER ST UNIT 26
Practice Address - Street 2:
Practice Address - City:MARSHVILLE
Practice Address - State:NC
Practice Address - Zip Code:28103-1348
Practice Address - Country:US
Practice Address - Phone:704-904-9674
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-30
Last Update Date:2012-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator