Burton, Elvin Thomaseo

Burton, Elvin Thomaseo is an individual health care provider with primary practice located at 51 N Dunlap St Ste. G145, Memphis TN 38105-4625. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Clinical Child & Adolescent. Behavioral Health & Social Service Providers / Clinical Child & Adolescent is his primary health care specialty. Burton, Elvin Thomaseo can be contacted via phone (901) 287-5565.

Contact Information

Primary practice address
51 N Dunlap St Ste. G145 Memphis TN 38105-4625
Phone: (901) 287-5565
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X 3295 Tennessee
Behavioral Health & Social Service Providers / Clinical 103TC0700X 9642 Massachusetts
Behavioral Health & Social Service Providers / Clinical Child & Adolescent 103TC2200X PS019677 Pennsylvania

Profile Details

NPI number 1518210079
LBN Legal business name Burton, Elvin Thomaseo
Credentials PH.D.
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 22nd, 2012
Last updated Nov 15th, 2022 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1518210079 NPPES
Tennessee MEDICAID Q014670

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