Burton, Loren J

Burton, Loren J is an individual health care provider with primary practice located at 403 E Madison St , South Bend IN 46617-2322. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Burton, Loren J can be contacted via phone (574) 533-1234.

Contact Information

Primary practice address
403 E Madison St South Bend IN 46617-2322
Fax: (574) 537-2652
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X 20040808A Indiana

Profile Details

NPI number 1851367361
LBN Legal business name Burton, Loren J
Credentials PHD HSPP
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 24th, 2006
Last updated Sep 27th, 2010 - about 14 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 1851367361 NPPES
Indiana MEDICAID 200200760A

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