Provider Demographics
NPI:1528385010
Name:BURNETT, VERNYCE KIM (EDD, LPC-S)
Entity Type:Individual
Prefix:MS
First Name:VERNYCE
Middle Name:KIM
Last Name:BURNETT
Suffix:
Gender:F
Credentials:EDD, LPC-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1711 E CENTRAL TEXAS EXPY STE 300B
Mailing Address - Street 2:
Mailing Address - City:KILLEEN
Mailing Address - State:TX
Mailing Address - Zip Code:76541-9120
Mailing Address - Country:US
Mailing Address - Phone:832-721-7903
Mailing Address - Fax:
Practice Address - Street 1:1711 E CENTRAL TEXAS EXPY STE 300B
Practice Address - Street 2:
Practice Address - City:KILLEEN
Practice Address - State:TX
Practice Address - Zip Code:76541-9120
Practice Address - Country:US
Practice Address - Phone:832-721-7903
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-23
Last Update Date:2020-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX18389101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional