Provider Demographics
NPI:1578971479
Name:BURTON, KRISTY (LPC)
Entity Type:Individual
Prefix:
First Name:KRISTY
Middle Name:
Last Name:BURTON
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:KRISTY
Other - Middle Name:
Other - Last Name:HUFFER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 2129
Mailing Address - Street 2:
Mailing Address - City:BENTON
Mailing Address - State:AR
Mailing Address - Zip Code:72018-2129
Mailing Address - Country:US
Mailing Address - Phone:501-205-4570
Mailing Address - Fax:888-305-8084
Practice Address - Street 1:2940 W SUNSET AVE STE D
Practice Address - Street 2:
Practice Address - City:SPRINGDALE
Practice Address - State:AR
Practice Address - Zip Code:72762-4974
Practice Address - Country:US
Practice Address - Phone:501-205-4570
Practice Address - Fax:888-305-8084
Is Sole Proprietor?:No
Enumeration Date:2014-07-24
Last Update Date:2023-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
MO2022028840101YP2500X
ARP1707327101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health