Provider Demographics
NPI:1922000645
Name:BURNS, KRISTINE STRATTON (LCSW)
Entity Type:Individual
Prefix:MS
First Name:KRISTINE
Middle Name:STRATTON
Last Name:BURNS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 YORK ST
Mailing Address - Street 2:
Mailing Address - City:ANSONIA
Mailing Address - State:CT
Mailing Address - Zip Code:06401-2130
Mailing Address - Country:US
Mailing Address - Phone:203-732-7811
Mailing Address - Fax:
Practice Address - Street 1:405 HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:WATERBURY
Practice Address - State:CT
Practice Address - Zip Code:06708-3419
Practice Address - Country:US
Practice Address - Phone:203-755-0270
Practice Address - Fax:203-755-5791
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT03-1821651041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical