Individual provider Active NPI

Pascale Raoul Burns, BA, MA

  • Professional Counselor
  • Park Ridge, IL
National Provider Identifier
1700303252
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
178012637 Issued in IL
Practice address
36 Main St
Park Ridge, IL 60068-4059
Phone
(847) 692-6692
NPI assigned
Aug 25, 2017
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 178012637 IL Primary

Addresses

Primary practice location

36 Main St
Park Ridge, IL 60068-4059

Mailing address

36 Main St
Park Ridge, IL 60068-4059
Phone (847) 692-6692

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
Bachelor of Arts, Master of Arts

State licenses

LicenseStateTypeSpecialty
178012637ILMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Park Ridge Psychological Services, LTD PastSince Jul 24, 2022 Accepting new patients
OT Laura LLC PastSince Jul 24, 2022 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1503619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1700303252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36 MAIN ST",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600684059",
            "telephone_number": "847-692-6692"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36 MAIN ST",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600684059",
            "telephone_number": "847-692-6692"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURNS",
        "first_name": "PASCALE",
        "middle_name": "RAOUL",
        "credential": "BA, MA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-08-25",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "178012637",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Park Ridge, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.