Provider Demographics
NPI:1770026395
Name:BURNS, GRANT JR
Entity Type:Individual
Prefix:MR
First Name:GRANT
Middle Name:
Last Name:BURNS
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9708 ANDOVER DR
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70127-2212
Mailing Address - Country:US
Mailing Address - Phone:504-782-4751
Mailing Address - Fax:
Practice Address - Street 1:3520 GENERAL DEGAULLE DR STE 4070
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70114
Practice Address - Country:US
Practice Address - Phone:504-245-2440
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-11-30
Last Update Date:2018-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No101Y00000XBehavioral Health & Social Service ProvidersCounselor