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NPI Code Detail

MEDICARE: TAIRA NICHOLE BURNS LPC-MHSP, NCC

MEDICARE: TAIRA NICHOLE BURNS LPC-MHSP, NCC
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
1101YP2500XProfessional Counselor4735TN

General Provider Information

NPI Number : 1609477058
Entity Type Code : Individual
Provider Name (Legal Business Name) : TAIRA NICHOLE BURNS LPC-MHSP, NCC
Provider Business Mailing Address
First Line : 408 N CEDAR BLUFF RD STE 305
Second Line :
City : KNOXVILLE
State : TN
Zip : 37923-3648
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 408 N CEDAR BLUFF RD STE 305
Second Line :
City : KNOXVILLE
State : TN
Zip : 37923-3648
Country : US
Telephone Number : 423-754-0682
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/03/2020
Last Update Date : 11/03/2020

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Directions to “ TAIRA NICHOLE BURNS LPC-MHSP, NCC” Practice Location

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