1902062003 NPI number — RICHARD BURNS MS, LMFT, NCC

Table of content: RICHARD BURNS MS, LMFT, NCC (NPI 1902062003)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1902062003 NPI number — RICHARD BURNS MS, LMFT, NCC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BURNS
Provider First Name:
RICHARD
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MS, LMFT, NCC
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1902062003
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/23/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 120448
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NEW
Provider Business Mailing Address State Name:
MN
Provider Business Mailing Address Postal Code:
55122
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
763-340-2311
Provider Business Mailing Address Fax Number:
763-340-2340

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1030 COUNTY ROAD E W STE 220
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SAINT PAUL
Provider Business Practice Location Address State Name:
MN
Provider Business Practice Location Address Postal Code:
55126-8153
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
763-300-0387
Provider Business Practice Location Address Fax Number:
763-340-2340
Provider Enumeration Date:
07/29/2008

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 106H00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 106H00000X , with the licence number: 2365 , registered in the state of MN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1902062003 . This is a "UCARE/ BHP" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 1902062003 . This is a "TRICARE" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 1902062003 . This is a "BLUE CROSS BLUE SHIELD OF MN" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 1902062003 . This is a "MEDICA/ UBH" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 1902062003 . This is a "PREFERRED ONE" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 1902062003 . This is a "METROPOLITAN HEALTH PLAN" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 1902062003 . This is a "HUMANA/ LIFESYNCH" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 1902062003 . This is a "HEALTHPARTNERS" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 1902062003 , issued by the state of ( MN ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com