Individual
CARRIE A BURRIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
24 W RAILROAD AVE SUITE 16, RAY, ND 58849
(701) 568-5600
Mailing address
1500 14TH ST W STE 290, WILLISTON, ND 58801-4078
(701) 334-6442
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
5619
ND
1041C0700X
Clinical Social Worker
LCSW-35774
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5619
ND BOARD OF SW EXAMINERS
ND
01
—
LCSW-35774
ID BUREAU OF OCCUPATIONAL LICENSES
ID
Enumeration date
05/28/2013
Last updated
05/21/2019
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