Provider Demographics
NPI:1407373715
Name:PSU, LLC
Entity Type:Organization
Organization Name:PSU, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / CLINICAL THERAPIST
Authorized Official - Prefix:DR
Authorized Official - First Name:A MONIQUE
Authorized Official - Middle Name:
Authorized Official - Last Name:BURNS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, ACSW, LCSW
Authorized Official - Phone:317-418-9149
Mailing Address - Street 1:851 NW 45TH ST STE 104
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64116-4613
Mailing Address - Country:US
Mailing Address - Phone:317-418-9149
Mailing Address - Fax:816-883-8274
Practice Address - Street 1:851 NW 45TH ST STE 104
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64116-4613
Practice Address - Country:US
Practice Address - Phone:317-418-9149
Practice Address - Fax:816-883-8274
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PSU, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-08-28
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2017023471101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty