Provider Demographics
NPI:1316524309
Name:BURTON, EMILY (LCSW-C)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:BURTON
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9627 PHILADELPHIA RD STE 160
Mailing Address - Street 2:
Mailing Address - City:ROSEDALE
Mailing Address - State:MD
Mailing Address - Zip Code:21237-4157
Mailing Address - Country:US
Mailing Address - Phone:410-780-5203
Mailing Address - Fax:
Practice Address - Street 1:1122 KENILWORTH DR STE 416
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21204-2148
Practice Address - Country:US
Practice Address - Phone:443-451-5122
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-25
Last Update Date:2021-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD24957104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker