Provider Demographics
NPI:1306063896
Name:BURTON, MELANIE E (LCSW, LADC, CASAC)
Entity type:Individual
Prefix:MS
First Name:MELANIE
Middle Name:E
Last Name:BURTON
Suffix:
Gender:F
Credentials:LCSW, LADC, CASAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:56 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:EAST HAMPTON
Mailing Address - State:CT
Mailing Address - Zip Code:06424-1029
Mailing Address - Country:US
Mailing Address - Phone:860-467-6191
Mailing Address - Fax:203-284-8302
Practice Address - Street 1:393 CENTER ST.
Practice Address - Street 2:CHILD & FAMILY PSYCHOTHERAPY CENTER
Practice Address - City:WALLINGFORD
Practice Address - State:CT
Practice Address - Zip Code:06492-5000
Practice Address - Country:US
Practice Address - Phone:860-657-8868
Practice Address - Fax:203-284-8302
Is Sole Proprietor?:No
Enumeration Date:2007-04-19
Last Update Date:2015-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT00919101YA0400X
NY16829101YA0400X
CT0076861041C0700X
NY0796081041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)