Maris A Burton, MASTERS DEGREE

Key facts

NPI

1972746907

Entity type

Individual (NPI type 1)

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X

Practice address

2105 Commerce Dr
Cayce, SC 29033-1524

Phone

(803) 796-6179

NPI assigned

Apr 7, 2009

Sex

Female

Sole proprietor

Yes

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jun 29, 2011.

{
    "created_epoch": "1239062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1309305600000",
    "number": "1972746907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2105 COMMERCE DR",
            "city": "CAYCE",
            "state": "SC",
            "postal_code": "290331524",
            "telephone_number": "803-796-6179"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2105 COMMERCE DR",
            "city": "CAYCE",
            "state": "SC",
            "postal_code": "290331524",
            "telephone_number": "803-796-6179"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURTON",
        "first_name": "MARIS",
        "middle_name": "A",
        "name_prefix": "Ms.",
        "credential": "MASTERS DEGREE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-04-07",
        "last_updated": "2011-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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All providers in Cayce, SC · Mental Health Clinic/Center (Including Community Mental Health Center) in South Carolina