Provider Demographics
NPI:1730533175
Name:BURTON, LINDA (CPSS, CHW)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:
Last Name:BURTON
Suffix:
Gender:F
Credentials:CPSS, CHW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8726 WOODWARD AVE
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48202-2135
Mailing Address - Country:US
Mailing Address - Phone:313-833-2500
Mailing Address - Fax:
Practice Address - Street 1:8726 WOODWARD AVE
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48202-2135
Practice Address - Country:US
Practice Address - Phone:313-833-2500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-22
Last Update Date:2025-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI172V00000X, 175T00000X
247200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist
No172V00000XOther Service ProvidersCommunity Health Worker
No247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other