Burner, Lisa D

Burner, Lisa D is an sole proprietor health care provider with primary practice located at 259 Oakdale Ave East , Crestview FL 32536. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder). Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) is her primary health care specialty. Burner, Lisa D can be contacted via phone (850) 682-1234.

Contact Information

Primary practice address
259 Oakdale Ave East Crestview FL 32536
Phone: (850) 682-1234
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X SW 6803 Florida
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X 2871 Florida

Profile Details

NPI number 1750472841
LBN Legal business name Burner, Lisa D
Credentials LCSW CAP
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 27th, 2006
Last updated Apr 27th, 2018 - about 7 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 1750472841 NPPES
Florida MEDICAID 766762100

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