Provider Demographics
NPI:1861799819
Name:BURNS, KERI RENEE (PLPC)
Entity type:Individual
Prefix:MRS
First Name:KERI
Middle Name:RENEE
Last Name:BURNS
Suffix:
Gender:F
Credentials:PLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14401 OCEAN SIDE DR
Mailing Address - Street 2:
Mailing Address - City:FLORISSANT
Mailing Address - State:MO
Mailing Address - Zip Code:63034-3038
Mailing Address - Country:US
Mailing Address - Phone:314-609-5377
Mailing Address - Fax:314-524-3804
Practice Address - Street 1:9167 W FLORISSANT AVE
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63136-1420
Practice Address - Country:US
Practice Address - Phone:314-524-3800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-26
Last Update Date:2011-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2010011194101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional