Healthcare Provider Details

I. General information

NPI: 1497350540
Provider Name (Legal Business Name): JENNIFER BURNS, LMHC,
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/04/2020
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

35 VILLAGE RD STE 100
MIDDLETON MA
01949-1238
US

IV. Provider business mailing address

17 PARADISE RD
IPSWICH MA
01938-1221
US

V. Phone/Fax

Practice location:
  • Phone: 617-336-3858
  • Fax:
Mailing address:
  • Phone: 978-509-2688
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JENNIFER BURNS
Title or Position: LICENSED MENTAL HEALTH COUNSELOR
Credential: LMHC
Phone: 617-336-3858