Provider Demographics
NPI:1548938889
Name:BURKART, ANNE FENTON (LCAS-A)
Entity type:Individual
Prefix:MS
First Name:ANNE
Middle Name:FENTON
Last Name:BURKART
Suffix:
Gender:F
Credentials:LCAS-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4806 S HILL VIEW DR
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28210-2333
Mailing Address - Country:US
Mailing Address - Phone:704-957-9227
Mailing Address - Fax:
Practice Address - Street 1:7810 PINEVILLE MATTHEWS RD STE 5
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28226-5300
Practice Address - Country:US
Practice Address - Phone:980-236-1660
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-01
Last Update Date:2021-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCLCAS-27443101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty