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General NPI Number Information
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NPI Number | 1679734768
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Entity Type | Individual
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Provider Name | ERIK DAVID BURNS ADICTIONS COUNSELOR
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Gender | Male
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Dates
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Enumeration Date | 06/20/2008
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Last Update Date | 02/24/2011
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Provider Practice Location Address
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Address Line | 221 N ROGERS ST CENTERSTONE RECOVERY HOUSE
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City | BLOOMINGTON
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State | IN
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Zip | 47404-3968
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Country | US
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Telephone | 812-337-2424
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Fax |
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Provider Business Mailing Address
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Address Line | 15 S OUTER DR
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City | MARTINSVILLE
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State | IN
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Zip | 46151-3367
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Country | US
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Telephone | 765-318-4064
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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