Provider Demographics
NPI:1750673851
Name:BURNS, CRAIG W (LMSW)
Entity type:Individual
Prefix:
First Name:CRAIG
Middle Name:W
Last Name:BURNS
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1182 ALA KIPA ST APT 406
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96819-1218
Mailing Address - Country:US
Mailing Address - Phone:808-781-2378
Mailing Address - Fax:
Practice Address - Street 1:2022 7TH AVE NW
Practice Address - Street 2:
Practice Address - City:EAST GRAND FORKS
Practice Address - State:MN
Practice Address - Zip Code:56721-1243
Practice Address - Country:US
Practice Address - Phone:701-620-0302
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-06
Last Update Date:2023-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND5749104100000X
HI1875104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker