Provider Demographics
NPI:1821854704
Name:BURNS, ELIZABETH CHIARA (OSC)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:CHIARA
Last Name:BURNS
Suffix:
Gender:F
Credentials:OSC
Other - Prefix:
Other - First Name:BETSY
Other - Middle Name:
Other - Last Name:BURNS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:OSC
Mailing Address - Street 1:7 ELIZABETH ST
Mailing Address - Street 2:
Mailing Address - City:RED HOOK
Mailing Address - State:NY
Mailing Address - Zip Code:12571-1706
Mailing Address - Country:US
Mailing Address - Phone:847-269-4011
Mailing Address - Fax:
Practice Address - Street 1:7 ELIZABETH ST
Practice Address - Street 2:
Practice Address - City:RED HOOK
Practice Address - State:NY
Practice Address - Zip Code:12571-1706
Practice Address - Country:US
Practice Address - Phone:847-269-4011
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-27
Last Update Date:2024-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY278232347101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty