Provider Demographics
NPI:1124243209
Name:BURSTON'S CONSULTING AND COUNSELING SERVICES, LLC
Entity type:Organization
Organization Name:BURSTON'S CONSULTING AND COUNSELING SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER-ADMINISTRATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:LUTHER
Authorized Official - Last Name:BURSTON
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:336-613-5515
Mailing Address - Street 1:857 KNOWLES RD
Mailing Address - Street 2:
Mailing Address - City:REIDSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27320-8633
Mailing Address - Country:US
Mailing Address - Phone:336-613-5515
Mailing Address - Fax:336-634-0449
Practice Address - Street 1:1117 S MAIN ST
Practice Address - Street 2:
Practice Address - City:REIDSVILLE
Practice Address - State:NC
Practice Address - Zip Code:27320-5313
Practice Address - Country:US
Practice Address - Phone:336-613-5515
Practice Address - Fax:336-634-0449
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
Not Answered103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty