Active NPI
Kaleb Burningham, LMFT, PHD
- Marriage & Family Therapist
- Roseville, MN
National Provider Identifier
1871244137
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 3959
- Practice address
- 1611 County Road B W Ste 204
Roseville, MN 55113-4053 - Phone
- (801) 995-8313
- NPI assigned
- Jan 18, 2022
- Last updated
- Oct 1, 2024
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 001960-01 | NY | |
| Marriage & Family Therapist | 106H00000X | 3959 | MN | Primary |
Addresses
Primary practice location
1611 County Road B W Ste 204
Roseville, MN 55113-4053
Mailing address
15093 S Halter Way
Bluffdale, UT 84065-1885
Phone (801) 995-8313
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
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 001960-01 | NY | MD | Marriage & Family Therapist |
| 3959 | MN | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1642464000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1727740800000",
"number": "1871244137",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15093 S HALTER WAY",
"city": "BLUFFDALE",
"state": "UT",
"postal_code": "840651885",
"telephone_number": "801-995-8313"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1611 COUNTY ROAD B W STE 204",
"city": "ROSEVILLE",
"state": "MN",
"postal_code": "551134053",
"telephone_number": "801-995-8313"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BURNINGHAM",
"first_name": "KALEB",
"name_prefix": "Dr.",
"credential": "LMFT, PHD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2022-01-18",
"last_updated": "2024-10-01",
"certification_date": "2024-10-01",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "NY",
"license": "001960-01",
"primary": false
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "MN",
"license": "3959",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Roseville, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.