Provider Demographics
NPI:1548928880
Name:BURNS, JADE (LCPC)
Entity type:Individual
Prefix:
First Name:JADE
Middle Name:
Last Name:BURNS
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 COMILL CT APT 1B
Mailing Address - Street 2:
Mailing Address - City:OWINGS MILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21117-3450
Mailing Address - Country:US
Mailing Address - Phone:240-605-9318
Mailing Address - Fax:
Practice Address - Street 1:205 E JOPPA RD STE 106
Practice Address - Street 2:
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21286-3203
Practice Address - Country:US
Practice Address - Phone:410-337-0007
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-03
Last Update Date:2021-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC11603101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health