MEDICARE: MRS. SUSAN LYNN BURNEY M.ED

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	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1508949322
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. SUSAN LYNN BURNEY M.ED

Provider Business Mailing Address
First Line	:	230 ASHWOOD LN
Second Line	:
City	:	ORCHARD PARK
State	:	NY
Zip	:	14127-4852
Country	:	US
Telephone Number	:	716-662-1851
Fax Number	:

Provider Business Practice Location Address
First Line	:	923 MAIN ST
Second Line	:	CHILD AND FAMILY SERVICES
City	:	BUFFALO
State	:	NY
Zip	:	14203-1121
Country	:	US
Telephone Number	:	716-881-2591
Fax Number	:

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

Provider Enumeration Date	:	10/23/2006
Last Update Date	:	07/08/2007

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