Provider Demographics
NPI:1588823231
Name:BURNS, LAURIE ANN (MS, MFT)
Entity Type:Individual
Prefix:MS
First Name:LAURIE
Middle Name:ANN
Last Name:BURNS
Suffix:
Gender:F
Credentials:MS, MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2277 TOWNSGATE RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:WESTLAKE VILLAGE
Mailing Address - State:CA
Mailing Address - Zip Code:91361-2406
Mailing Address - Country:US
Mailing Address - Phone:805-778-9151
Mailing Address - Fax:805-379-4514
Practice Address - Street 1:2277 TOWNSGATE RD
Practice Address - Street 2:SUITE 200
Practice Address - City:WESTLAKE VILLAGE
Practice Address - State:CA
Practice Address - Zip Code:91361-2406
Practice Address - Country:US
Practice Address - Phone:805-778-9151
Practice Address - Fax:805-379-4514
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-07
Last Update Date:2009-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC39328106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist