Provider Demographics
NPI:1629415906
Name:BURNS, KERRI (CMHC)
Entity Type:Individual
Prefix:
First Name:KERRI
Middle Name:
Last Name:BURNS
Suffix:
Gender:F
Credentials:CMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:313 E 1200 S
Mailing Address - Street 2:SUITE 104
Mailing Address - City:OREM
Mailing Address - State:UT
Mailing Address - Zip Code:84058-6972
Mailing Address - Country:US
Mailing Address - Phone:801-377-1595
Mailing Address - Fax:801-768-4636
Practice Address - Street 1:313 E 1200 S
Practice Address - Street 2:SUITE 104
Practice Address - City:OREM
Practice Address - State:UT
Practice Address - Zip Code:84058-6972
Practice Address - Country:US
Practice Address - Phone:801-377-1595
Practice Address - Fax:801-768-4636
Is Sole Proprietor?:No
Enumeration Date:2013-05-28
Last Update Date:2023-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT324491-6004101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health