1346536257 NPI number — MARGARET AMANDA BURTS LCSW PLLC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1346536257 NPI number — MARGARET AMANDA BURTS LCSW PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MARGARET AMANDA BURTS LCSW PLLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1346536257
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/20/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 173
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BRASSTOWN
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28902-0173
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
828-837-0869
Provider Business Mailing Address Fax Number:
828-837-8410

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
225 VALLEY RIVER AVE
Provider Second Line Business Practice Location Address:
SUITE D
Provider Business Practice Location Address City Name:
MURPHY
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28906-2988
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
828-837-0869
Provider Business Practice Location Address Fax Number:
828-837-8410
Provider Enumeration Date:
06/20/2011

Additional Information

Authorized Official

Authorized Official Last Name:
BURTS
Authorized Official First Name:
MARGARET
Authorized Official Middle Name:
AMANDA
Authorized Official Title or Position:
OWNER/AGENT/PROVIDER
Authorized Official Telephone Number:
828-837-0869

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  C002825 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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