Healthcare Provider Details

I. General information

NPI: 1285401869
Provider Name (Legal Business Name): ERIC BURDEN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/05/2023
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

76 PIERCE ST
STOUGHTON MA
02072-3035
US

IV. Provider business mailing address

76 PIERCE ST
STOUGHTON MA
02072-3035
US

V. Phone/Fax

Practice location:
  • Phone: 857-201-0023
  • Fax:
Mailing address:
  • Phone: 857-201-0023
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: