Provider Demographics
NPI:1295910206
Name:BURNS, CATHERINE E (PHD)
Entity type:Individual
Prefix:
First Name:CATHERINE
Middle Name:E
Last Name:BURNS
Suffix:
Gender:F
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 245
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VT
Mailing Address - Zip Code:05477-0245
Mailing Address - Country:US
Mailing Address - Phone:802-922-1612
Mailing Address - Fax:
Practice Address - Street 1:183 TALCOTT RD
Practice Address - Street 2:SUITE 206
Practice Address - City:WILLISTON
Practice Address - State:VT
Practice Address - Zip Code:05495-2089
Practice Address - Country:US
Practice Address - Phone:802-922-1612
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-09
Last Update Date:2015-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT048-0000857103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT1295910206OtherBLUE CROSS/BLUE SHIELD OF VERMONT
VT2677532OtherCIGNA
VT419252OtherTRICARE
VT1011333Medicaid