=====================================================
General NPI Number Information
=====================================================
NPI Number | 1295996262
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ANN KATHRYN BURNS LMFT
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/22/2008
-----------------------------------------------------
Last Update Date | 12/28/2012
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 85 5TH AVE #912
-----------------------------------------------------
City | NEW YORK
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10003-3019
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 917-338-6294
-----------------------------------------------------
Fax | 212-281-1816
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 345 W 145TH ST 5B2
-----------------------------------------------------
City | NEW YORK
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10031-5302
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 917-338-6294
-----------------------------------------------------
Fax | 212-281-1618
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 106H00000X
-----------------------------------------------------
Taxonomy Name | Marriage & Family Therapist
-----------------------------------------------------
License Number | 000489-1
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------