Provider Demographics
NPI:1225059702
Name:BURNS, SHAWNDA P (LMHC, CAP)
Entity Type:Individual
Prefix:MS
First Name:SHAWNDA
Middle Name:P
Last Name:BURNS
Suffix:
Gender:F
Credentials:LMHC, CAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12505 ORANGE DR
Mailing Address - Street 2:SUITE 907
Mailing Address - City:DAVIE
Mailing Address - State:FL
Mailing Address - Zip Code:33330-4300
Mailing Address - Country:US
Mailing Address - Phone:954-358-5788
Mailing Address - Fax:954-358-5790
Practice Address - Street 1:12505 ORANGE DR
Practice Address - Street 2:SUITE 907
Practice Address - City:DAVIE
Practice Address - State:FL
Practice Address - Zip Code:33330-4300
Practice Address - Country:US
Practice Address - Phone:954-358-5788
Practice Address - Fax:954-358-5790
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL2497W101YA0400X
FLMH8451101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health