Provider Demographics
NPI:1477271815
Name:BURRUS, KARA
Entity Type:Individual
Prefix:
First Name:KARA
Middle Name:
Last Name:BURRUS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6504 26TH ST APT A
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79407-1336
Mailing Address - Country:US
Mailing Address - Phone:806-281-2385
Mailing Address - Fax:
Practice Address - Street 1:6500 QUAKER AVE STE D
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79413-5138
Practice Address - Country:US
Practice Address - Phone:806-687-5413
Practice Address - Fax:806-317-1588
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-22
Last Update Date:2022-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX81716101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX81716OtherTEXAS STATE BOARD OF EXAMINERS OF PROFESSIONAL COUNSELORS