Provider Demographics
NPI:1942342332
Name:BURNS, JOHN CLARENCE III (EDD, LPC, NCC)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:CLARENCE
Last Name:BURNS
Suffix:III
Gender:M
Credentials:EDD, LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2308 WALLINGTON DR
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:GA
Mailing Address - Zip Code:31721-8900
Mailing Address - Country:US
Mailing Address - Phone:299-435-7374
Mailing Address - Fax:
Practice Address - Street 1:1216 DAWSON RD
Practice Address - Street 2:SUITE 114
Practice Address - City:ALBANY
Practice Address - State:GA
Practice Address - Zip Code:31707-3889
Practice Address - Country:US
Practice Address - Phone:229-883-7774
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC000169101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health