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NPI Code Detail

MEDICARE: LAURIE BURNETT LMSW

MEDICARE: LAURIE BURNETT LMSW
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
1104100000XSocial Worker074268-1NY

General Provider Information

NPI Number : 1508985078
Entity Type Code : Individual
Provider Name (Legal Business Name) : LAURIE BURNETT LMSW
Provider Business Mailing Address
First Line : 31 NORTH RD
Second Line :
City : TILLSON
State : NY
Zip : 12486-1001
Country : US
Telephone Number : 845-658-9446
Fax Number :
Provider Business Practice Location Address
First Line : 88 FOX HOLLOW RD
Second Line :
City : RHINEBECK
State : NY
Zip : 12572-3639
Country : US
Telephone Number : 845-876-3789
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/28/2007
Last Update Date : 07/08/2007

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Directions to “ LAURIE BURNETT LMSW” Practice Location

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