Individual provider Active NPI

Kathleen Eleanor Burns, MA

  • Clinical Psychologist
  • Atlanta, GA
National Provider Identifier
1841640588
Registry record updated Nov 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY004630 Issued in GA
Practice address
1074 Ponce de Leon Ave NE
Atlanta, GA 30306-4216
Phone
(404) 939-7151
NPI assigned
Jun 14, 2016
Last updated
Nov 6, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X NU
Psychologist 103T00000X NU
Clinical Psychologist 103TC0700X PSY004630 GA Primary

Addresses

Primary practice location

1074 Ponce de Leon Ave NE
Atlanta, GA 30306-4216

Mailing address

1074 Ponce de Leon Ave NE
Atlanta, GA 30306-4216
Phone (404) 939-7151

Other practice location 1

444 Center St
Manchester, CT 06040
Phone (860) 646-3888

Other practice location 2

77 Mill St
Westfield, MA 01085-4598
Phone (413) 568-6141

Other practice location 3

77 Mill St
Westfield, MA 01085-4598
Phone (413) 568-6141

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231026000580 GA Practitioner - Clinical Psychologist 1951757079

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
98.79 of 100Reported as group
Quality
98.74
Improvement activities
40
Cost
83.11

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts, Doctor of Philosophy

NPI Registry JSON

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

{
    "created_epoch": "1465862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699228800000",
    "number": "1841640588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1074 PONCE DE LEON AVE NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303064216",
            "telephone_number": "404-939-7151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1074 PONCE DE LEON AVE NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303064216",
            "telephone_number": "404-939-7151"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "444 Center St",
            "address_purpose": "LOCATION",
            "city": "Manchester",
            "state": "CT",
            "postal_code": "06040",
            "country_code": "US",
            "telephone_number": "860-646-3888",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "77 Mill St",
            "address_purpose": "LOCATION",
            "city": "Westfield",
            "state": "MA",
            "postal_code": "010854598",
            "country_code": "US",
            "telephone_number": "413-568-6141",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "77 Mill St",
            "address_purpose": "LOCATION",
            "city": "Westfield",
            "state": "MA",
            "postal_code": "010854598",
            "country_code": "US",
            "telephone_number": "413-568-6141",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BURNS",
        "first_name": "KATHLEEN",
        "middle_name": "ELEANOR",
        "credential": "MA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-14",
        "last_updated": "2023-11-06",
        "certification_date": "2023-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "GA",
            "license": "PSY004630",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.