Burns, Nichole

Burns, Nichole is an individual health care provider with primary practice located at 21 Montauk Avene , New London CT 06320-4906. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is her primary health care specialty. Burns, Nichole can be contacted via phone (860) 271-4715.

Contact Information

Primary practice address
21 Montauk Avene New London CT 06320-4906
Phone: (860) 271-4715
Fax: (860) 271-4797
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X
Behavioral Health & Social Service Providers / Clinical 1041C0700X

Profile Details

NPI number 1003230624
LBN Legal business name Burns, Nichole
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 18th, 2014
Last updated Nov 8th, 2021 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1003230624 NPPES
Connecticut MEDICAID 008059339

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