Provider Demographics
NPI:1295889442
Name:BURNS-KHAN, IMAN (LISW)
Entity type:Individual
Prefix:MS
First Name:IMAN
Middle Name:
Last Name:BURNS-KHAN
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1441 29TH ST STE 209
Mailing Address - Street 2:
Mailing Address - City:WEST DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50266-1309
Mailing Address - Country:US
Mailing Address - Phone:515-505-3313
Mailing Address - Fax:641-472-4609
Practice Address - Street 1:1441 29TH ST STE 209
Practice Address - Street 2:
Practice Address - City:WEST DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50266-1309
Practice Address - Country:US
Practice Address - Phone:515-505-3313
Practice Address - Fax:641-472-4609
Is Sole Proprietor?:No
Enumeration Date:2007-01-23
Last Update Date:2020-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA06439104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA107314000OtherIOWA PLAN