Courtney D Burress, LCSW
Individual provider Active NPI Clinical Social Worker · Apache Junction, AZ
NPI 1912227653 · NPPES record last updated Jan 26, 2021
Key facts
- NPI
- 1912227653
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- AP9961 (AZ)
- Practice address
- 2080 W Southern Ave BLDG B10
Apache Junction, AZ 85120-7653 - Phone
- (480) 351-2850
- Fax
- (480) 351-2851
- NPI assigned
- Jun 4, 2010
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AP9961 | AZ | MD | Clinical Social Worker |
| 5857 | OK | MD | Pediatric Occupational Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 5857 | OK | |
| Clinical Social Worker | 1041C0700X | AP9961 | AZ | Yes |
Addresses
Primary practice location
2080 W Southern Ave BLDG B10
Apache Junction, AZ 85120-7653
Mailing address
PO Box 10097
Casa Grande, AZ 85130-0020
Phone (520) 836-3446
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All providers in Apache Junction, AZ · Clinical Social Worker in Arizona
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 26, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.