Healthcare Provider Details

I. General information

NPI: 1306607247
Provider Name (Legal Business Name): DIANA BURTON-WEBB LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DIANA BURTON-WEBB LCSW

II. Dates (important events)

Enumeration Date: 01/18/2024
Last Update Date: 08/18/2025
Certification Date: 08/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3451 UNION BLVD
SAINT LOUIS MO
63115-1142
US

IV. Provider business mailing address

5471 DR MARTIN LUTHER KING DR
SAINT LOUIS MO
63112-4265
US

V. Phone/Fax

Practice location:
  • Phone: 314-888-0970
  • Fax:
Mailing address:
  • Phone: 314-367-5820
  • Fax: 314-367-7010

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number004364
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number004364
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: