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General NPI Number Information
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NPI Number | 1801490263
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Entity Type | Organization
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Legal Business Name | SHARICE BURNETT, LCSW, LLC
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Dates
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Enumeration Date | 11/25/2020
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Last Update Date | 01/12/2024
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Provider Practice Location Address
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Address Line | 2009 NE EDGEWATER DRIVE
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City | PORTLAND
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State | OR
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Zip | 97211
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Country | US
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Telephone | 971-227-6840
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Fax |
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Provider Business Mailing Address
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Address Line | 10350 N VANCOUVER WAY STE 408
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City | PORTLAND
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State | OR
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Zip | 97217-7530
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Country | US
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Telephone | 971-227-6840
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Fax |
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Authorized Official
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Title or Position | MENTAL HEALTH THERAPIST
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Name | SHARICE BURNETT
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Credential |
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Telephone | 971-227-6840
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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 |
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License Number State |
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