Provider Demographics
NPI:1144758806
Name:BURNS, CAITLYN MARIE (MS LMFT)
Entity Type:Individual
Prefix:
First Name:CAITLYN
Middle Name:MARIE
Last Name:BURNS
Suffix:
Gender:F
Credentials:MS LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:140 ROUTE 10 W # 1019
Mailing Address - Street 2:
Mailing Address - City:RANDOLPH
Mailing Address - State:NJ
Mailing Address - Zip Code:07869-1542
Mailing Address - Country:US
Mailing Address - Phone:973-440-8859
Mailing Address - Fax:
Practice Address - Street 1:140 ROUTE 10 W # 1019
Practice Address - Street 2:
Practice Address - City:RANDOLPH
Practice Address - State:NJ
Practice Address - Zip Code:07869-1542
Practice Address - Country:US
Practice Address - Phone:973-440-8859
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-25
Last Update Date:2022-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
NJ37FA00001000106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health