MEDICARE: MS. BARBARA BURTON 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
1	1041C0700X	Clinical Social Worker	001346	MO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	260145	OTHER	MO	MHN
2	10849354	OTHER	MO	CAQH

General Provider Information

NPI Number	:	1356340095
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. BARBARA BURTON LCSW

Provider Business Mailing Address
First Line	:	9374 OLIVE BLVD
Second Line	:	SUITE 202
City	:	SAINT LOUIS
State	:	MO
Zip	:	63132-3253
Country	:	US
Telephone Number	:	314-997-5900
Fax Number	:	314-997-5900

Provider Business Practice Location Address
First Line	:	9374 OLIVE BLVD
Second Line	:	SUITE 202
City	:	SAINT LOUIS
State	:	MO
Zip	:	63132-3253
Country	:	US
Telephone Number	:	314-997-5900
Fax Number	:	314-997-5900

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

Provider Enumeration Date	:	07/15/2005
Last Update Date	:	10/29/2009

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