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NPI Code Detail

MEDICARE: RANDI BURNS LMHC

MEDICARE: RANDI BURNS LMHC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor001309IA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1477858843
Entity Type Code : Individual
Provider Name (Legal Business Name) : RANDI BURNS LMHC
Provider Business Mailing Address
First Line : 520 11TH ST NW
Second Line :
City : CEDAR RAPIDS
State : IA
Zip : 52405-3811
Country : US
Telephone Number : 319-398-3562
Fax Number : 319-398-3501
Provider Business Practice Location Address
First Line : 721 S 5TH ST
Second Line :
City : MANCHESTER
State : IA
Zip : 52057-2048
Country : US
Telephone Number : 563-927-6700
Fax Number : 563-927-6703
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/17/2011
Last Update Date : 01/17/2011

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