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General NPI Number Information
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NPI Number | 1902626278
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Entity Type | Organization
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Legal Business Name | ELISABETH BURN MENTAL HEALTH COUNSELING, PLLC
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Dates
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Enumeration Date | 10/11/2024
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Last Update Date | 10/11/2024
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Provider Practice Location Address
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Address Line | 1432 NIAGARA ST
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City | BUFFALO
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State | NY
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Zip | 14213-1302
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Country | US
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Telephone | 716-866-0074
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Fax |
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Provider Business Mailing Address
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Address Line | 4498 MAIN STREET SUITE #4 1387
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City | BUFFALO
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State | NY
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Zip | 14226
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Country | US
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Telephone | 716-866-0074
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Fax |
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Authorized Official
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Title or Position | MEMBER/OWNER
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Name | ELISABETH LAURA BURN
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Credential | LMHC
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Telephone | 716-866-0074
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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