Provider Demographics
NPI:1417594177
Name:BURNS, JENNA (LPC)
Entity Type:Individual
Prefix:
First Name:JENNA
Middle Name:
Last Name:BURNS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6448 E HWY 290 STE E114
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78723-1076
Mailing Address - Country:US
Mailing Address - Phone:512-561-0609
Mailing Address - Fax:
Practice Address - Street 1:6448 E HWY 290 STE E114
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78723-1076
Practice Address - Country:US
Practice Address - Phone:512-561-0609
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-02
Last Update Date:2019-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX78174101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health