Provider Demographics
NPI:1164258737
Name:BURNS, JENNIFER A (PSYD, LADC I)
Entity type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:A
Last Name:BURNS
Suffix:
Gender:F
Credentials:PSYD, LADC I
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33 FOLLY MILL RD
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:MA
Mailing Address - Zip Code:01952-1020
Mailing Address - Country:US
Mailing Address - Phone:978-421-5447
Mailing Address - Fax:
Practice Address - Street 1:33 FOLLY MILL RD
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:MA
Practice Address - Zip Code:01952-1020
Practice Address - Country:US
Practice Address - Phone:978-421-5447
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-11
Last Update Date:2024-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA23747103TA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TA0400XBehavioral Health & Social Service ProvidersPsychologistAddiction (Substance Use Disorder)Group - Multi-Specialty