Provider Demographics
NPI:1912977679
Name:BURTON-VUNESKY, KRISTINA D (MSW, LCSW, PSYD)
Entity Type:Individual
Prefix:DR
First Name:KRISTINA
Middle Name:D
Last Name:BURTON-VUNESKY
Suffix:
Gender:F
Credentials:MSW, LCSW, PSYD
Other - Prefix:DR
Other - First Name:KRISTINA
Other - Middle Name:D
Other - Last Name:BURTON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MSW, LCSW, PSYD
Mailing Address - Street 1:729 W CENTER CIR
Mailing Address - Street 2:SUITE 103
Mailing Address - City:NIXA
Mailing Address - State:MO
Mailing Address - Zip Code:65714-7001
Mailing Address - Country:US
Mailing Address - Phone:417-724-0700
Mailing Address - Fax:417-724-0710
Practice Address - Street 1:729 W CENTER CIR
Practice Address - Street 2:SUITE 103
Practice Address - City:NIXA
Practice Address - State:MO
Practice Address - Zip Code:65714-7001
Practice Address - Country:US
Practice Address - Phone:417-724-0700
Practice Address - Fax:417-724-0710
Is Sole Proprietor?:No
Enumeration Date:2006-01-25
Last Update Date:2009-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20040054351041C0700X
MO2008009366103TC0700X, 103TH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TH0100XBehavioral Health & Social Service ProvidersPsychologistHealth Service
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO496125006Medicaid
MO9567100OtherAETNA
MO201291OtherBLUE CROSS BLUE SHIELD
MO201291OtherBLUE CROSS BLUE SHIELD