Provider Demographics
NPI:1437921301
Name:BURROWS, AIDAN KEITH (LAC)
Entity Type:Individual
Prefix:
First Name:AIDAN
Middle Name:KEITH
Last Name:BURROWS
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 HILLVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:MORRIS PLAINS
Mailing Address - State:NJ
Mailing Address - Zip Code:07950-2115
Mailing Address - Country:US
Mailing Address - Phone:973-879-9243
Mailing Address - Fax:
Practice Address - Street 1:287 BOULEVARD
Practice Address - Street 2:
Practice Address - City:POMPTON PLAINS
Practice Address - State:NJ
Practice Address - Zip Code:07444-1726
Practice Address - Country:US
Practice Address - Phone:201-320-6334
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-24
Last Update Date:2023-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37AC00748200101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health