Provider Demographics
NPI:1679734768
Name:BURNS, ERIK DAVID (ADICTIONS COUNSELOR)
Entity type:Individual
Prefix:MR
First Name:ERIK
Middle Name:DAVID
Last Name:BURNS
Suffix:
Gender:M
Credentials:ADICTIONS COUNSELOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 S OUTER DR
Mailing Address - Street 2:
Mailing Address - City:MARTINSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46151-3367
Mailing Address - Country:US
Mailing Address - Phone:765-318-4064
Mailing Address - Fax:
Practice Address - Street 1:221 N ROGERS ST
Practice Address - Street 2:CENTERSTONE RECOVERY HOUSE
Practice Address - City:BLOOMINGTON
Practice Address - State:IN
Practice Address - Zip Code:47404-3968
Practice Address - Country:US
Practice Address - Phone:812-337-2424
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-20
Last Update Date:2011-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)