Provider Demographics
NPI:1861730368
Name:BURNS, A MONIQUE (PHD, ACSW, LCSW)
Entity type:Individual
Prefix:DR
First Name:A MONIQUE
Middle Name:
Last Name:BURNS
Suffix:
Gender:F
Credentials:PHD, ACSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:851 NW 45TH ST STE 104
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64116-4613
Mailing Address - Country:US
Mailing Address - Phone:317-418-9149
Mailing Address - Fax:816-883-8274
Practice Address - Street 1:851 NW 45TH ST STE 104
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64116-4613
Practice Address - Country:US
Practice Address - Phone:317-418-9149
Practice Address - Fax:816-883-8274
Is Sole Proprietor?:No
Enumeration Date:2013-01-18
Last Update Date:2019-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34005766A1041C0700X
ORL61371041C0700X
KS47171041C0700X
GACSW0050771041C0700X
MO20170234711041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical