Provider Demographics
NPI:1811394570
Name:BURNS, TANESHA (LMHC)
Entity Type:Individual
Prefix:MRS
First Name:TANESHA
Middle Name:
Last Name:BURNS
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:107 MAYFIELD DR
Mailing Address - Street 2:
Mailing Address - City:SANFORD
Mailing Address - State:FL
Mailing Address - Zip Code:32771-6823
Mailing Address - Country:US
Mailing Address - Phone:407-474-1610
Mailing Address - Fax:
Practice Address - Street 1:209 SAN CARLOS AVE STE 111A
Practice Address - Street 2:
Practice Address - City:SANFORD
Practice Address - State:FL
Practice Address - Zip Code:32771
Practice Address - Country:US
Practice Address - Phone:407-431-7866
Practice Address - Fax:407-386-9611
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-24
Last Update Date:2018-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH15463101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health