Healthcare Provider Details

I. General information

NPI: 1720164742
Provider Name (Legal Business Name): MARGARET AMANDA BURTS MSW, LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/31/2006
Last Update Date: 10/24/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

281 VALLEY RIVER AVENUE MURPHY COUNSELING SERVICES
MURPHY NC
28906
US

IV. Provider business mailing address

468 CALER RD P.O. BOX 173
BRASSTOWN NC
28902-8532
US

V. Phone/Fax

Practice location:
  • Phone: 828-835-7372
  • Fax: 828-835-8282
Mailing address:
  • Phone: 828-837-9761
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberC002825
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCSW003183
License Number StateGA

VII. Legacy identifiers

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

# 1
Identifier6002577
Identifier TypeMEDICAID
Identifier StateNC
Identifier Issuer

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: