Provider Demographics
NPI:1902990716
Name:BURTON, LINDY S (LCSW)
Entity Type:Individual
Prefix:MS
First Name:LINDY
Middle Name:S
Last Name:BURTON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:MARION
Other - Middle Name:LINDY SMITH
Other - Last Name:BURTON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW
Mailing Address - Street 1:1400 FOOTHILL DR STE 24
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84108-2392
Mailing Address - Country:US
Mailing Address - Phone:801-581-0422
Mailing Address - Fax:801-581-0764
Practice Address - Street 1:1400 FOOTHILL DR STE 24
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84108-2392
Practice Address - Country:US
Practice Address - Phone:801-581-0422
Practice Address - Fax:801-581-0764
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2007-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT376325-35011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical