Provider Demographics
NPI:1427346717
Name:JACKSON BURNS, JAMES MORGAN (LPC)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:MORGAN
Last Name:JACKSON BURNS
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:JAMES
Other - Middle Name:MORGAN
Other - Last Name:BURNS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:1430 COLLIER ST
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78704-2911
Mailing Address - Country:US
Mailing Address - Phone:512-445-7787
Mailing Address - Fax:512-440-4059
Practice Address - Street 1:1430 COLLIER ST
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78704-2911
Practice Address - Country:US
Practice Address - Phone:512-445-7787
Practice Address - Fax:512-440-4059
Is Sole Proprietor?:No
Enumeration Date:2011-07-20
Last Update Date:2019-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YP2500X
TX65572101YP2500X
MO2012012904101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional