Provider Demographics
NPI:1770651614
Name:BURNS, KEITH (MS, CM)
Entity Type:Individual
Prefix:MR
First Name:KEITH
Middle Name:
Last Name:BURNS
Suffix:
Gender:M
Credentials:MS, CM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:135 W 21ST ST
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46202-1337
Mailing Address - Country:US
Mailing Address - Phone:317-920-0052
Mailing Address - Fax:317-466-1710
Practice Address - Street 1:6100 N KEYSTONE AVE STE 237
Practice Address - Street 2:TRANSITIONAL ASSISTANCE SERVICES
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46220-2426
Practice Address - Country:US
Practice Address - Phone:317-466-1740
Practice Address - Fax:317-466-1710
Is Sole Proprietor?:No
Enumeration Date:2006-11-30
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health