MEDICARE: MS. BARBARA JEAN BURNS LMSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	ISW02058	RI
2	104100000X	Social Worker	065138-1	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	065138	OTHER	NY	UNIVERSITY OF THE STATE OF NEW YORK EDUCATION DEPARTMENT OFFICE OF THE PROFESSIO
2	ISW02058	OTHER	RI	RHOE ISLAND DEPARTMENT OF HEALTH

General Provider Information

NPI Number	:	1508955774
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. BARBARA JEAN BURNS LMSW

Provider Business Mailing Address
First Line	:	430 NIAGARA ST
Second Line	:
City	:	BUFFALO
State	:	NY
Zip	:	14201-1886
Country	:	US
Telephone Number	:	716-856-2587
Fax Number	:	716-856-2608

Provider Business Practice Location Address
First Line	:	430 NIAGARA ST
Second Line	:
City	:	BUFFALO
State	:	NY
Zip	:	14201-1886
Country	:	US
Telephone Number	:	716-856-2587
Fax Number	:	716-856-2608

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/12/2006
Last Update Date	:	07/19/2012

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