Healthcare Provider Details

I. General information

NPI: 1598398588
Provider Name (Legal Business Name): SARAH MARIE HOLLAND BURNS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/18/2020
Last Update Date: 05/08/2026
Certification Date: 05/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 SOVEREIGN CT STE 119E
BALLWIN MO
63011-4441
US

IV. Provider business mailing address

301 SOVEREIGN CT STE 119E
BALLWIN MO
63011-4441
US

V. Phone/Fax

Practice location:
  • Phone: 314-228-6011
  • Fax:
Mailing address:
  • Phone: 314-228-6011
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number2024003369
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: