Active NPI
Laura Ellen Burnham, MA, LPC, LCAS
- Mental Health Counselor
- Fayetteville, NC
National Provider Identifier
1831233097
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 5074
- Practice address
- 2529 Raeford Rd
Suite C
Fayetteville, NC 28305-5098 - Phone
- (910) 689-3524
- Fax
- (910) 401-1926
- NPI assigned
- Feb 19, 2007
- 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 | 5074 | NC | Primary |
Addresses
Primary practice location
2529 Raeford Rd
Suite C
Fayetteville, NC 28305-5098
Mailing address
2529 Raeford Rd
Suite C
Fayetteville, NC 28305-5098
Phone (910) 689-3524
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 61047787 | Medicaid | NC |
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 |
|---|---|---|---|
| 5074 | NC | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171843200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1427932800000",
"number": "1831233097",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2529 RAEFORD RD",
"address_2": "SUITE C",
"city": "FAYETTEVILLE",
"state": "NC",
"postal_code": "283055098",
"telephone_number": "910-689-3524",
"fax_number": "910-401-1926"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2529 RAEFORD RD",
"address_2": "SUITE C",
"city": "FAYETTEVILLE",
"state": "NC",
"postal_code": "283055098",
"telephone_number": "910-689-3524",
"fax_number": "910-401-1926"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BURNHAM",
"first_name": "LAURA",
"middle_name": "ELLEN",
"name_prefix": "Mrs.",
"credential": "MA, LPC, LCAS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-02-19",
"last_updated": "2015-04-02",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NC",
"license": "5074",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "61047787",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fayetteville, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.