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NPI 1205326196

NPI 1205326196 : JAY WESLEY BURROWS MSW, LCSW, CADC, CCS : ERIE, PA

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General NPI Number Information
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    NPI Number           |    1205326196
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    Entity Type          |    Individual 
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    Provider Name        |    JAY WESLEY BURROWS MSW, LCSW, CADC, CCS
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    05/16/2018
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    Last Update Date     |    12/10/2025
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Provider Practice Location Address
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    Address Line         |    4906 RICHMOND ST 
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    City                 |    ERIE
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    State                |    PA
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    Zip                  |    16509-1978
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    Country              |    US
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    Telephone            |    814-864-4226
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    3678 DOGLEG TRL 
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    City                 |    ERIE
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    State                |    PA
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    Zip                  |    16510-5964
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    Country              |    US
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    Telephone            |    
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    1041C0700X
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    Taxonomy Name        |    Clinical Social Worker
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    License Number       |    CW018779
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    License Number State |    PA
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