Provider Demographics
NPI:1427811777
Name:BURRUSS, KAHLIA (MS, LMHC-P)
Entity type:Individual
Prefix:
First Name:KAHLIA
Middle Name:
Last Name:BURRUSS
Suffix:
Gender:F
Credentials:MS, LMHC-P
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:92 SLATE CREEK DR APT 11
Mailing Address - Street 2:
Mailing Address - City:CHEEKTOWAGA
Mailing Address - State:NY
Mailing Address - Zip Code:14227-2838
Mailing Address - Country:US
Mailing Address - Phone:716-393-6100
Mailing Address - Fax:
Practice Address - Street 1:22 DEPOT ST
Practice Address - Street 2:
Practice Address - City:POTSDAM
Practice Address - State:NY
Practice Address - Zip Code:13676-1229
Practice Address - Country:US
Practice Address - Phone:716-393-6100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-31
Last Update Date:2024-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health