Kelly Burris, LMFT

Primary specialty

CounselorTaxonomy code 101Y00000X

Practice address

657 Camino de Los Mares
241
San Clemente, CA 92673

Phone

(949) 391-8278

Fax

(949) 391-8278

NPI assigned

Apr 19, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1366329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1679917736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "657 CAMINO DE LOS MARES",
            "address_2": "241",
            "city": "SAN CLEMENTE",
            "state": "CA",
            "postal_code": "92673",
            "telephone_number": "949-391-8278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "657 CAMINO DE LOS MARES",
            "address_2": "241",
            "city": "SAN CLEMENTE",
            "state": "CA",
            "postal_code": "92673",
            "telephone_number": "949-391-8278",
            "fax_number": "949-391-8278"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "18302 Irvine Blvd",
            "address_2": "Suite 300",
            "address_purpose": "LOCATION",
            "city": "Tustin",
            "state": "CA",
            "postal_code": "927803435",
            "country_code": "US",
            "telephone_number": "714-617-2853",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BURRIS",
        "first_name": "KELLY",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-19",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Counselor in San Clemente, CA
• Providers in San Clemente, CA by specialty
• Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.