Provider Demographics
NPI:1386258614
Name:BURR, ADRIENNE M (LCSW)
Entity type:Individual
Prefix:
First Name:ADRIENNE
Middle Name:M
Last Name:BURR
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20377 SW ACACIA ST STE 110
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-0781
Mailing Address - Country:US
Mailing Address - Phone:888-717-9355
Mailing Address - Fax:949-287-5439
Practice Address - Street 1:20377 SW ACACIA ST STE 110
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-0781
Practice Address - Country:US
Practice Address - Phone:888-717-9355
Practice Address - Fax:949-287-5439
Is Sole Proprietor?:No
Enumeration Date:2020-09-03
Last Update Date:2023-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1154361041C0700X
CA955531041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical