Provider Demographics
NPI:1790506756
Name:BURTON, ELIZABETH CHELSEY (MA, ALC, NCC)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:CHELSEY
Last Name:BURTON
Suffix:
Gender:F
Credentials:MA, ALC, NCC
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:
Other - Last Name:MADISON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5844 WOODWARD RD
Mailing Address - Street 2:
Mailing Address - City:MOUNT OLIVE
Mailing Address - State:AL
Mailing Address - Zip Code:35117-3520
Mailing Address - Country:US
Mailing Address - Phone:480-335-1404
Mailing Address - Fax:
Practice Address - Street 1:300 OFFICE PARK DR
Practice Address - Street 2:
Practice Address - City:MOUNTAIN BRK
Practice Address - State:AL
Practice Address - Zip Code:35223-2474
Practice Address - Country:US
Practice Address - Phone:205-538-3099
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-22
Last Update Date:2024-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL04546101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health