Provider Demographics
NPI:1467566653
Name:BURNSPOWER, KATHLEEN MARY (MED LMHC)
Entity Type:Individual
Prefix:MS
First Name:KATHLEEN
Middle Name:MARY
Last Name:BURNSPOWER
Suffix:
Gender:F
Credentials:MED LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 VIKING TER
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01604-1428
Mailing Address - Country:US
Mailing Address - Phone:508-438-5580
Mailing Address - Fax:
Practice Address - Street 1:198 RUSSELL ST
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01609-2200
Practice Address - Country:US
Practice Address - Phone:508-363-4544
Practice Address - Fax:508-753-5100
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-18
Last Update Date:2012-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA829101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health