Provider Demographics
NPI:1396920294
Name:BURNS, KATE H (LICSW)
Entity type:Individual
Prefix:MRS
First Name:KATE
Middle Name:H
Last Name:BURNS
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:KATE
Other - Middle Name:
Other - Last Name:DIOGO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:22 BUFFUM ST
Mailing Address - Street 2:APT 2
Mailing Address - City:SALEM
Mailing Address - State:MA
Mailing Address - Zip Code:01970-2308
Mailing Address - Country:US
Mailing Address - Phone:774-239-2483
Mailing Address - Fax:
Practice Address - Street 1:66 CLIFTON AVE
Practice Address - Street 2:
Practice Address - City:MARBLEHEAD
Practice Address - State:MA
Practice Address - Zip Code:01945-1737
Practice Address - Country:US
Practice Address - Phone:781-631-8273
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-01-09
Last Update Date:2016-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1132351041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical