Provider Demographics
NPI:1922417344
Name:BURRUS, KRISTEN (LMFT)
Entity Type:Individual
Prefix:
First Name:KRISTEN
Middle Name:
Last Name:BURRUS
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:248 W COLLEEN CT
Mailing Address - Street 2:
Mailing Address - City:GARDNER
Mailing Address - State:KS
Mailing Address - Zip Code:66030-1299
Mailing Address - Country:US
Mailing Address - Phone:816-200-6434
Mailing Address - Fax:
Practice Address - Street 1:11261 STRANG LINE RD
Practice Address - Street 2:
Practice Address - City:LENEXA
Practice Address - State:KS
Practice Address - Zip Code:66215-4040
Practice Address - Country:US
Practice Address - Phone:816-200-6434
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-11
Last Update Date:2015-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS2640106H00000X
KS1348101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)