Active NPI
Colleen A. Burns, MA LMHC LADCI BHDR
- Mental Health Counselor
- Brookline, MA
National Provider Identifier
1407996861
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 4955
- Practice address
- 1170 Beacon St
Brookline, MA 02446-3963 - Phone
- (617) 470-4499
- Fax
- (617) 277-2524
- NPI assigned
- Feb 7, 2007
- Last updated
- Sep 30, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 4955 | MA | Primary |
Addresses
Primary practice location
1170 Beacon St
Brookline, MA 02446-3963
Mailing address
1093 Beacon St Ste 307
Brookline, MA 02446-5623
Phone (617) 470-4499
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| LM0950 | Other | MA | BCBS PROVIDER NUMBER |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | colleenbb@restorebodybalance.com | Direct |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4955 | MA | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170806400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1601424000000",
"number": "1407996861",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1093 BEACON ST STE 307",
"city": "BROOKLINE",
"state": "MA",
"postal_code": "024465623",
"telephone_number": "617-470-4499",
"fax_number": "617-277-2524"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1170 BEACON ST",
"city": "BROOKLINE",
"state": "MA",
"postal_code": "024463963",
"telephone_number": "617-470-4499",
"fax_number": "617-277-2524"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BURNS",
"first_name": "COLLEEN",
"middle_name": "A.",
"name_prefix": "Mrs.",
"credential": "MA LMHC LADCI BHDR",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-02-07",
"last_updated": "2020-09-30",
"certification_date": "2020-09-30",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "MA",
"license": "4955",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS PROVIDER NUMBER",
"identifier": "LM0950",
"state": "MA"
}
],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "colleenbb@restorebodybalance.com",
"affiliation": "N",
"endpointDescription": "email",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "1093 Beacon St Ste 307",
"city": "Brookline",
"state": "MA",
"country_code": "US",
"postal_code": "024465623",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Brookline, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.