Basic Information
| Provider Information | |||||||||
| NPI: | 1689165771 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BURROWS | ||||||||
| FirstName: | CIARA | ||||||||
| MiddleName: | O'MEGAN | ||||||||
| NamePrefix: | MISS | ||||||||
| NameSuffix: | |||||||||
| Credential: | LMSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 71 | ||||||||
| Address2: | |||||||||
| City: | ELBA | ||||||||
| State: | AL | ||||||||
| PostalCode: | 363230071 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3344750683 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 908 20TH ST S | ||||||||
| Address2: | |||||||||
| City: | BIRMINGHAM | ||||||||
| State: | AL | ||||||||
| PostalCode: | 352052610 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2059344108 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/23/2018 | ||||||||
| LastUpdateDate: | 05/31/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 05/31/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 104100000X | 3803G | AL | N | Behavioral Health & Social Service Providers | Social Worker | 1041C0700X | 4272C | AL | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.