MEDICARE: RICHARD BURNS MSW; LCSW; DIPLOMATE

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
1	1041C0700X	Clinical Social Worker	LCS10340	CA

General Provider Information

NPI Number	:	1508885062
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RICHARD BURNS MSW; LCSW; DIPLOMATE

Provider Business Mailing Address
First Line	:	2052 GLENWOOD RD
Second Line	:
City	:	GLENDALE
State	:	CA
Zip	:	91201-1341
Country	:	US
Telephone Number	:	818-953-7445
Fax Number	:	818-953-7445

Provider Business Practice Location Address
First Line	:	2060 N VERMONT AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90027-1919
Country	:	US
Telephone Number	:	323-664-7681
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/18/2006
Last Update Date	:	07/08/2007

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