Healthcare Provider Details

I. General information

NPI: 1194235390
Provider Name (Legal Business Name): VERONICA LYNN BURTON LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/03/2017
Last Update Date: 02/28/2025
Certification Date: 02/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

840 INTERSTATE DR
GRAYSON KY
41143-1768
US

IV. Provider business mailing address

PO BOX 790
ASHLAND KY
41105-0790
US

V. Phone/Fax

Practice location:
  • Phone: 866-233-1955
  • Fax: 606-329-1530
Mailing address:
  • Phone: 606-329-8588
  • Fax: 606-329-8195

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number255231
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: