Crystal Dawn Burns, PLPC
Individual provider Active NPI Professional Counselor · Fredericktown, MO
NPI 1679705669 · NPPES record last updated Aug 10, 2009
Key facts
- NPI
- 1679705669
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Professional Counselor 101YP2500X
- License
- 2009023308 (MO)
- Practice address
- 1800 Madison 257
Fredericktown, MO 63645-8273 - Phone
- (573) 783-4400
- Fax
- (573) 783-4409
- NPI assigned
- Aug 10, 2009
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2009023308 | MO | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Faith Tabernacle World Outreach Inc | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 2009023308 | MO | Yes |
Addresses
Primary practice location
1800 Madison 257
Fredericktown, MO 63645-8273
Mailing address
734 Highway Aa
Farmington, MO 63640-7075
Phone (573) 701-0054
Other providers in Fredericktown, MO
- Brost & Strohmeyer Family Eye Care PC
- Alyssa Jene' Brown
- Krystal Brunelle
- Julie Marie Buford
- Edward Burke
- Timothy G Busch
- Taite Byerly
- Karah Cain
- Chands' Medical Office of Fredericktown LLC
- Jamee Lynn Clark
All providers in Fredericktown, MO · Professional Counselor in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 10, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.