Tina D Burton, M.ED., M.S., CMT

Individual provider Active NPI Community/Behavioral Health Agency · Erial, NJ

NPI 1871027573 · NPPES record last updated Apr 19, 2017

Key facts

NPI
1871027573
Entity type
Individual (NPI type 1)
Primary specialty
Community/Behavioral Health Agency 251S00000X
License
M1143 (PA)
Practice address
33 Chevy Chase Rd
Erial, NJ 08081-4328
Phone
(856) 366-7064
NPI assigned
Apr 19, 2017
Sex
Female
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Master of Education, Master of Science

State licenses

LicenseStateTypeSpecialty
M1143PAMDCommunity/Behavioral Health Agency

Practice roles

OrganizationSpecialtyStatusNew patients
Hope Community/Behavioral Health Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X M1143 PA Yes

Addresses

Primary practice location

33 Chevy Chase Rd
Erial, NJ 08081-4328

Mailing address

33 Chevy Chase Rd
Erial, NJ 08081-4328
Phone (856) 366-7064

Other identifiers

IdentifierTypeStateIssuer
0064050MedicaidNJ

Other names

  • Tina D Frazier Other name

Other providers in Erial, NJ

All providers in Erial, NJ · Community/Behavioral Health Agency in New Jersey

Sources for this page

Verify at the official NPI Registry.