Provider Demographics
NPI:1396414967
Name:BURKEEN, ARIANNA JADE
Entity Type:Individual
Prefix:
First Name:ARIANNA
Middle Name:JADE
Last Name:BURKEEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2100 W CORNWALLIS DR STE O
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27408-7015
Mailing Address - Country:US
Mailing Address - Phone:336-337-5469
Mailing Address - Fax:336-660-2563
Practice Address - Street 1:2100 W CORNWALLIS DR STE O
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27408-7015
Practice Address - Country:US
Practice Address - Phone:336-337-5469
Practice Address - Fax:336-660-2563
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-08
Last Update Date:2021-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0163641041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical