Individual
ANDREA BURNS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCPC
Contact information
Practice address
102 W KENWOOD AVE STE 120A, DECATUR, IL 62526-4368
(217) 520-1047
(217) 520-1047
Mailing address
102 W KENWOOD AVE STE 120, DECATUR, IL 62526-6380
(217) 520-1047
(217) 876-2840
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
180010478
IL
101YP2500X
Professional Counselor
180.010478
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
370982024-002
—
IL
Enumeration date
03/24/2016
Last updated
01/23/2025
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