Provider Demographics
NPI:1558754754
Name:BURNETT, JOHN KNOX (LMHC)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:KNOX
Last Name:BURNETT
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6330 34TH AVE SW
Mailing Address - Street 2:UNIT B
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98126-3186
Mailing Address - Country:US
Mailing Address - Phone:425-202-5716
Mailing Address - Fax:
Practice Address - Street 1:6330 34TH AVE SW
Practice Address - Street 2:UNIT B
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98126-3186
Practice Address - Country:US
Practice Address - Phone:425-202-5716
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-12
Last Update Date:2016-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH 60604834101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health