Provider Demographics
NPI:1679682744
Name:BURNS, TAMIKA S (LPC-S, LSOTP, MA, MS)
Entity Type:Individual
Prefix:
First Name:TAMIKA
Middle Name:S
Last Name:BURNS
Suffix:
Gender:F
Credentials:LPC-S, LSOTP, MA, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 23576
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77228-3576
Mailing Address - Country:US
Mailing Address - Phone:281-973-8708
Mailing Address - Fax:281-973-8753
Practice Address - Street 1:3811 AMBER ROSE LN
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77039-3349
Practice Address - Country:US
Practice Address - Phone:281-973-8705
Practice Address - Fax:281-973-8753
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2024-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX182552301Medicaid