Healthcare Provider Details

I. General information

NPI: 1336070390
Provider Name (Legal Business Name): ABIGAIL LORRAINE BURTON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/28/2026
Last Update Date: 05/28/2026
Certification Date: 05/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 SCOTT AVE
MORGANTOWN WV
26508-8853
US

IV. Provider business mailing address

102 KING DR
KINGWOOD WV
26537-1015
US

V. Phone/Fax

Practice location:
  • Phone: 304-292-8234
  • Fax:
Mailing address:
  • Phone: 989-513-1992
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number1072
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: