MEDICARE: JACQUELINE BURNS

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	101YP2500X	Professional Counselor	LPCC.0023296	CO

General Provider Information

NPI Number	:	1689560682
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JACQUELINE BURNS

Provider Business Mailing Address
First Line	:	PO BOX 6463
Second Line	:
City	:	BRECKENRIDGE
State	:	CO
Zip	:	80424-6463
Country	:	US
Telephone Number	:	207-807-9145
Fax Number	:

Provider Business Practice Location Address
First Line	:	PO BOX 6463
Second Line	:
City	:	BRECKENRIDGE
State	:	CO
Zip	:	80424
Country	:	US
Telephone Number	:	207-807-9145
Fax Number	:

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

Provider Enumeration Date	:	06/16/2025
Last Update Date	:	05/13/2026

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Directions to “ JACQUELINE BURNS ” Practice Location

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