MEDICARE: MR. ERIC BURTON LMSW, CADC

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
1	1041C0700X	Clinical Social Worker	008330	IA

General Provider Information

NPI Number	:	1093242083
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ERIC BURTON LMSW, CADC

Provider Business Mailing Address
First Line	:	601 HWY 6W,
Second Line	:	IOWA CITY VA HOSPITAL
City	:	IOWA CITY
State	:	IA
Zip	:	52246
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1535 1ST AVE SE.
Second Line	:	CEDAR RAPIDS VA CBOC
City	:	CEDAR RAPIDS
State	:	IA
Zip	:	52403
Country	:	US
Telephone Number	:	319-365-0898
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/22/2017
Last Update Date	:	05/22/2017

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