Healthcare Provider Details

I. General information

NPI: 1093242083
Provider Name (Legal Business Name): ERIC BURTON LMSW, CADC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/22/2017
Last Update Date: 05/22/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1535 1ST AVE SE. CEDAR RAPIDS VA CBOC
CEDAR RAPIDS IA
52403
US

IV. Provider business mailing address

601 HWY 6W, IOWA CITY VA HOSPITAL
IOWA CITY IA
52246
US

V. Phone/Fax

Practice location:
  • Phone: 319-365-0898
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number008330
License Number StateIA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: