Provider Demographics
NPI:1114071651
Name:BURNS, JOSEPH PETER (LMSW CSAP JD)
Entity Type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:PETER
Last Name:BURNS
Suffix:
Gender:M
Credentials:LMSW CSAP JD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:83 INDIAN TRL
Mailing Address - Street 2:
Mailing Address - City:MUNITH
Mailing Address - State:MI
Mailing Address - Zip Code:49259-9735
Mailing Address - Country:US
Mailing Address - Phone:517-879-2602
Mailing Address - Fax:517-879-2602
Practice Address - Street 1:83 INDIAN TRL
Practice Address - Street 2:
Practice Address - City:MUNITH
Practice Address - State:MI
Practice Address - Zip Code:49259-9735
Practice Address - Country:US
Practice Address - Phone:517-879-2602
Practice Address - Fax:517-879-2602
Is Sole Proprietor?:No
Enumeration Date:2007-01-22
Last Update Date:2011-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010166501041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical