Provider Demographics
NPI:1932907987
Name:BURNS, MARKUS R JR
Entity type:Individual
Prefix:
First Name:MARKUS
Middle Name:R
Last Name:BURNS
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:305 HERRING GULL LN
Mailing Address - Street 2:
Mailing Address - City:MICHIGAN CITY
Mailing Address - State:IN
Mailing Address - Zip Code:46360-7768
Mailing Address - Country:US
Mailing Address - Phone:219-214-7857
Mailing Address - Fax:
Practice Address - Street 1:4840 GRASSELLI ST
Practice Address - Street 2:
Practice Address - City:EAST CHICAGO
Practice Address - State:IN
Practice Address - Zip Code:46312-3503
Practice Address - Country:US
Practice Address - Phone:219-397-1085
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-05
Last Update Date:2025-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician