Provider Demographics
NPI:1437717840
Name:BURNS, MARIO ALEXANDER (LPC, CRC, NCC)
Entity Type:Individual
Prefix:DR
First Name:MARIO
Middle Name:ALEXANDER
Last Name:BURNS
Suffix:
Gender:M
Credentials:LPC, CRC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1420 DONELSON PIKE STE A5
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37217-2961
Mailing Address - Country:US
Mailing Address - Phone:615-366-1220
Mailing Address - Fax:
Practice Address - Street 1:1420 DONELSON PIKE STE A5
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37217-2961
Practice Address - Country:US
Practice Address - Phone:615-366-1220
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-31
Last Update Date:2019-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2016040038101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health