Provider Demographics
NPI:1427313089
Name:BURTON, ANGELA LYNN (LCSW)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:LYNN
Last Name:BURTON
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 1:300 PLAIN ST
Mailing Address - Street 2:
Mailing Address - City:BRAINTREE
Mailing Address - State:MA
Mailing Address - Zip Code:02184-7226
Mailing Address - Country:US
Mailing Address - Phone:339-226-2093
Mailing Address - Fax:
Practice Address - Street 1:300 PLAIN ST
Practice Address - Street 2:
Practice Address - City:BRAINTREE
Practice Address - State:MA
Practice Address - Zip Code:02184-7226
Practice Address - Country:US
Practice Address - Phone:339-226-2093
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-10
Last Update Date:2012-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA217718104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker