Provider Demographics
NPI:1114464195
Name:BURNS, AMBER (LCPC, LPC, ATR)
Entity type:Individual
Prefix:
First Name:AMBER
Middle Name:
Last Name:BURNS
Suffix:
Gender:F
Credentials:LCPC, LPC, ATR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2819 MOLAND ST
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53704-4532
Mailing Address - Country:US
Mailing Address - Phone:608-473-2435
Mailing Address - Fax:
Practice Address - Street 1:301 S BEDFORD ST
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53703-3691
Practice Address - Country:US
Practice Address - Phone:608-313-5955
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-27
Last Update Date:2025-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTBBH-LCPC-LIC-22142101YP2500X
19-064221700000X
WI11802-125101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt Therapist