Provider Demographics
NPI:1124106505
Name:BURDEN, VENEITA F (MED LMHC)
Entity type:Individual
Prefix:MRS
First Name:VENEITA
Middle Name:F
Last Name:BURDEN
Suffix:
Gender:F
Credentials:MED LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:518 GREAT RD
Mailing Address - Street 2:BOUNDARIES THERAPY CENTER
Mailing Address - City:ACTON
Mailing Address - State:MA
Mailing Address - Zip Code:01720-3415
Mailing Address - Country:US
Mailing Address - Phone:978-263-4878
Mailing Address - Fax:978-635-0386
Practice Address - Street 1:518 GREAT RD
Practice Address - Street 2:BOUNDARIES THERAPY CENTER
Practice Address - City:ACTON
Practice Address - State:MA
Practice Address - Zip Code:01720-3415
Practice Address - Country:US
Practice Address - Phone:978-263-4878
Practice Address - Fax:978-635-0386
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA4356101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health