Provider Demographics
NPI:1942260757
Name:BURNS, JAMES ADAM (PHD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:ADAM
Last Name:BURNS
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 8010
Mailing Address - Street 2:1 SOUTH MAIN STREET GENESIS COUNSELING SERVICES
Mailing Address - City:JANESVILLE
Mailing Address - State:WI
Mailing Address - Zip Code:53547-8010
Mailing Address - Country:US
Mailing Address - Phone:608-757-0404
Mailing Address - Fax:608-757-2319
Practice Address - Street 1:1 SOUTH MAIN STREET
Practice Address - Street 2:GENESIS COUNSELING SERVICES
Practice Address - City:JANESVILLE
Practice Address - State:WI
Practice Address - Zip Code:53545
Practice Address - Country:US
Practice Address - Phone:608-757-0404
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2492-057103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist