Provider Demographics
NPI:1568024578
Name:SANDERS-BURNETT, DEIRDRA EILEEN (LMHC)
Entity Type:Individual
Prefix:DR
First Name:DEIRDRA
Middle Name:EILEEN
Last Name:SANDERS-BURNETT
Suffix:
Gender:F
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:PO BOX 1536
Mailing Address - Street 2:
Mailing Address - City:WINTER HAVEN
Mailing Address - State:FL
Mailing Address - Zip Code:33882-1536
Mailing Address - Country:US
Mailing Address - Phone:863-224-3225
Mailing Address - Fax:863-324-3293
Practice Address - Street 1:1106 MEADOW LARK LN
Practice Address - Street 2:
Practice Address - City:WINTER HAVEN
Practice Address - State:FL
Practice Address - Zip Code:33884-2543
Practice Address - Country:US
Practice Address - Phone:863-224-3225
Practice Address - Fax:863-324-3293
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-01
Last Update Date:2019-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH8069101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health