Tianna Rene Burroughs, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

34006307A Issued in IN

Practice address

205 S Walnut St Ste 11
Bloomington, IN 47404-6118

Phone

(812) 287-8630

NPI assigned

Apr 13, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1586736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675641600000",
    "number": "1851910459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 S WALNUT ST STE 11",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474046118",
            "telephone_number": "812-287-8630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 S WALNUT ST STE 11",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474046118",
            "telephone_number": "812-287-8630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURROUGHS",
        "first_name": "TIANNA",
        "middle_name": "RENE",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-04-13",
        "last_updated": "2023-02-06",
        "certification_date": "2023-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TN",
            "license": "7246",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34006307A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael R Burns, N.P.
• Amy Beth Burrell
• Cloey Burris, RBT
• Kaylee Burris, RBT
• Lester Burris II
• Shauna Marie Burton, L. AC.
• Amanda Butcher
• Nicholas Gregory Butcher, M.S.
• Miriam Selah Buthelezi, LMFTA
• Dominque Butler, RBT

• Clinical Social Worker in Bloomington, IN
• Providers in Bloomington, IN by specialty
• Clinical Social Worker in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2023; 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.