Provider Demographics
NPI:1366510158
Name:BURRILL, IRENE E (LCSW)
Entity type:Individual
Prefix:
First Name:IRENE
Middle Name:E
Last Name:BURRILL
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:460 ROMAN CT
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17404-6421
Mailing Address - Country:US
Mailing Address - Phone:717-767-4218
Mailing Address - Fax:
Practice Address - Street 1:141 E MARKET ST
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17401-1221
Practice Address - Country:US
Practice Address - Phone:717-845-6624
Practice Address - Fax:717-845-6626
Is Sole Proprietor?:No
Enumeration Date:2006-12-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0135501041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical