Provider Demographics
NPI:1295996262
Name:BURNS, ANN KATHRYN (LMFT)
Entity type:Individual
Prefix:
First Name:ANN KATHRYN
Middle Name:
Last Name:BURNS
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 1:345 W 145TH ST
Mailing Address - Street 2:5B2
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10031-5302
Mailing Address - Country:US
Mailing Address - Phone:917-338-6294
Mailing Address - Fax:212-281-1618
Practice Address - Street 1:85 5TH AVE
Practice Address - Street 2:#912
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-3019
Practice Address - Country:US
Practice Address - Phone:917-338-6294
Practice Address - Fax:212-281-1816
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-22
Last Update Date:2012-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000489-1106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY80-0865853OtherTAX ID
NY33-0365843OtherTAX ID