Healthcare Provider Details

I. General information

NPI: 1972418267
Provider Name (Legal Business Name): MARIA ROSE BURITS LSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/19/2026
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1738 BLAKESLEE BOULEVARD DR W STE 2
LEHIGHTON PA
18235-9730
US

IV. Provider business mailing address

1738 BLAKESLEE BOULEVARD DR W STE 2
LEHIGHTON PA
18235-9730
US

V. Phone/Fax

Practice location:
  • Phone: 484-263-0197
  • Fax: 412-794-6159
Mailing address:
  • Phone: 484-263-0197
  • Fax: 412-794-6159

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSW144435
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberSW144435
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: