Provider Demographics
NPI:1215634555
Name:BURNS, STACY ANN (LMHC)
Entity type:Individual
Prefix:MRS
First Name:STACY
Middle Name:ANN
Last Name:BURNS
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 LONGMEADOW RD
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:MA
Mailing Address - Zip Code:02056-1509
Mailing Address - Country:US
Mailing Address - Phone:617-293-7723
Mailing Address - Fax:
Practice Address - Street 1:184 W MAIN ST UNIT 202
Practice Address - Street 2:
Practice Address - City:NORTON
Practice Address - State:MA
Practice Address - Zip Code:02766-1243
Practice Address - Country:US
Practice Address - Phone:508-565-8121
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-07
Last Update Date:2023-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA13442101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health