Individual
MRS. CLARYCE VERNA BURRIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW,CADACIV,NCAC II
Contact information
Practice address
1950 W 86TH ST, INDIANAPOLIS, IN 46260-2076
(317) 824-1725
Mailing address
1950 W 86TH ST, INDIANAPOLIS, IN 46260-2076
(317) 824-1725
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
TO BE GRANDFATHERED
IN
1041C0700X
Clinical Social Worker
Primary
340001113A
IN
Other
Enumeration date
02/15/2010
Last updated
02/15/2010
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