Provider Demographics
NPI:1588039218
Name:BURNS, CLIFTON GEORGE JR (LCPC)
Entity Type:Individual
Prefix:MR
First Name:CLIFTON
Middle Name:GEORGE
Last Name:BURNS
Suffix:JR
Gender:M
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:585 THORNHILL DR
Mailing Address - Street 2:UNIT 215
Mailing Address - City:CAROL STREAM
Mailing Address - State:IL
Mailing Address - Zip Code:60188-2764
Mailing Address - Country:US
Mailing Address - Phone:630-923-5838
Mailing Address - Fax:
Practice Address - Street 1:585 THORNHILL DR
Practice Address - Street 2:UNIT 215
Practice Address - City:CAROL STREAM
Practice Address - State:IL
Practice Address - Zip Code:60188-2764
Practice Address - Country:US
Practice Address - Phone:630-923-5838
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-07
Last Update Date:2015-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180009724101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional