Provider Demographics
NPI:1659234904
Name:BURNS, LORI DEVINE (MSW)
Entity type:Individual
Prefix:MRS
First Name:LORI
Middle Name:DEVINE
Last Name:BURNS
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2274
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSON
Mailing Address - State:WV
Mailing Address - Zip Code:25661-2274
Mailing Address - Country:US
Mailing Address - Phone:304-785-9815
Mailing Address - Fax:
Practice Address - Street 1:123 BEECHWOOD E
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:KY
Practice Address - Zip Code:40069-8563
Practice Address - Country:US
Practice Address - Phone:859-582-2929
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-12-04
Last Update Date:2025-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYTC000010581041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty