MEDICARE: ALYSON 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	101Y00000X	Counselor	6836	SC

General Provider Information

NPI Number	:	1922546225
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALYSON BURNS

Provider Business Mailing Address
First Line	:	1004 DELSEY ST
Second Line	:
City	:	NORTH CHARLESTON
State	:	SC
Zip	:	29405-4912
Country	:	US
Telephone Number	:	404-210-6088
Fax Number	:

Provider Business Practice Location Address
First Line	:	4400 MARBLEHEAD LN
Second Line	:
City	:	NORTH CHARLESTON
State	:	SC
Zip	:	29405-3221
Country	:	US
Telephone Number	:	404-210-6088
Fax Number	:

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

Provider Enumeration Date	:	02/07/2017
Last Update Date	:	03/25/2019

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Directions to “ ALYSON BURNS ” Practice Location

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