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NPI Code Detail

MEDICARE: MISS LYNNE MARIE BURROUGHS LCSW

MEDICARE: MISS LYNNE MARIE BURROUGHS LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social WorkerLCS15432CA

General Provider Information

NPI Number : 1043395049
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS LYNNE MARIE BURROUGHS LCSW
Provider Business Mailing Address
First Line : PO BOX 1116
Second Line :
City : CULVER CITY
State : CA
Zip : 90232-1116
Country : US
Telephone Number : 213-996-7321
Fax Number :
Provider Business Practice Location Address
First Line : 529 MAPLE AVE
Second Line :
City : LOS ANGELES
State : CA
Zip : 90013-1511
Country : US
Telephone Number : 213-430-6700
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/26/2006
Last Update Date : 07/08/2015

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Directions to “ MISS LYNNE MARIE BURROUGHS LCSW” Practice Location

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