NPIMap

Organization Active NPI

Michael T. Burns, Psy.D LTD

  • Community/Behavioral Health Agency
  • Crystal Lake, IL
National Provider Identifier
1578868808
Registry record updated Jan 18, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
071004478 Issued in IL
Legal business name
MICHAEL T. BURNS, PSY.D LTD
Practice address
610 Crystal Point Dr Ste 3
Crystal Lake, IL 60014-1400
Phone
(815) 455-0044
Fax
(815) 455-0080
NPI assigned
Jan 18, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Michael T. Burns, PSY.D
Title
President
Phone
(815) 455-0044

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 071004478 IL Primary

Addresses

Primary practice location

610 Crystal Point Dr Ste 3
Crystal Lake, IL 60014-1400

Mailing address

610 Crystal Point Dr Ste 3
Crystal Lake, IL 60014-1400
Phone (815) 455-0044

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1295308800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1295308800000",
    "number": "1578868808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "610 CRYSTAL POINT DR STE 3",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600141400",
            "telephone_number": "815-455-0044",
            "fax_number": "815-455-0080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 CRYSTAL POINT DR STE 3",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600141400",
            "telephone_number": "815-455-0044",
            "fax_number": "815-455-0080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL T. BURNS, PSY.D LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-18",
        "last_updated": "2011-01-18",
        "status": "A",
        "authorized_official_last_name": "BURNS",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "T.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "815-455-0044",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "IL",
            "license": "071004478",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crystal Lake, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.