Provider Demographics
NPI:1679843577
Name:BURNES & BURNES PSYCHOTHERAPY AND COUNSELING SERVICES
Entity type:Organization
Organization Name:BURNES & BURNES PSYCHOTHERAPY AND COUNSELING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOTHERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:LEONARD
Authorized Official - Last Name:BURNES
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW, ACSW, CAADC
Authorized Official - Phone:248-231-3568
Mailing Address - Street 1:7500 HAMBURG RD
Mailing Address - Street 2:
Mailing Address - City:BRIGHTON
Mailing Address - State:MI
Mailing Address - Zip Code:48116-9160
Mailing Address - Country:US
Mailing Address - Phone:248-231-3568
Mailing Address - Fax:
Practice Address - Street 1:794 W GRAND RIVER AVE
Practice Address - Street 2:
Practice Address - City:BRIGHTON
Practice Address - State:MI
Practice Address - Zip Code:48116-2392
Practice Address - Country:US
Practice Address - Phone:248-231-3568
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-09
Last Update Date:2012-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
C-02227OtherCAADC
MIOM97450022Medicare PIN