Healthcare Provider Details

I. General information

NPI: 1144359332
Provider Name (Legal Business Name): ESTHER BURTON LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/05/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1371 HIGHWAY 278 W
MONTICELLO AR
71655-9663
US

IV. Provider business mailing address

297 BOWSER RD
MONTICELLO AR
71655-9769
US

V. Phone/Fax

Practice location:
  • Phone: 870-367-2141
  • Fax: 870-367-2103
Mailing address:
  • Phone: 870-367-7279
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number1695-C
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: