Individual provider Active NPI

Stacie Nicole Burns I

  • Addiction (Substance Use Disorder) Counselor
  • Pontiac, MI
National Provider Identifier
1891262879
Registry record updated Oct 29, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
Practice address
239 State St
Pontiac, MI 48341-1363
Phone
(248) 335-5437
Fax
(248) 335-7766
NPI assigned
Oct 29, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 29, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X Primary

Addresses

Primary practice location

239 State St
Pontiac, MI 48341-1363

Mailing address

54 Seneca St
Pontiac, MI 48342-2349
Phone (248) 335-5437

Other practice location 1

54 Seneca St
Pontiac, MI 48342-2349
Phone (248) 334-7760

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

Practice roles

OrganizationSpecialtyStatusNew patients
Completion House Inc. Addiction (Substance Use Disorder) PastSince Feb 13, 2022 Accepting new patients

Organizations & group practices 1

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": "1540771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540771200000",
    "number": "1891262879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "54 SENECA ST",
            "city": "PONTIAC",
            "state": "MI",
            "postal_code": "483422349",
            "telephone_number": "248-335-5437",
            "fax_number": "248-836-0199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "239 STATE ST",
            "city": "PONTIAC",
            "state": "MI",
            "postal_code": "483411363",
            "telephone_number": "248-335-5437",
            "fax_number": "248-335-7766"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "54 Seneca St",
            "address_purpose": "LOCATION",
            "city": "Pontiac",
            "state": "MI",
            "postal_code": "483422349",
            "country_code": "US",
            "telephone_number": "248-334-7760",
            "fax_number": "248-836-0199",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BURNS",
        "first_name": "STACIE",
        "middle_name": "NICOLE",
        "name_suffix": "I",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-10-29",
        "last_updated": "2018-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pontiac, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2018; 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.