Provider Demographics
NPI:1003002536
Name:BURNS, SUSAN BEGIN (MA)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:BEGIN
Last Name:BURNS
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:SUSAN
Other - Middle Name:
Other - Last Name:BEGIN-BURNS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MA
Mailing Address - Street 1:2370 130TH AVE NE STE 106
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98005-1770
Mailing Address - Country:US
Mailing Address - Phone:425-881-9000
Mailing Address - Fax:425-746-8016
Practice Address - Street 1:2370 130TH AVE NE STE 106
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98005-1770
Practice Address - Country:US
Practice Address - Phone:425-881-9000
Practice Address - Fax:425-746-8016
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-18
Last Update Date:2007-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH00003581101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health