Provider Demographics
NPI:1609109263
Name:BURTON, JENNIFER CLARK (PHD)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:CLARK
Last Name:BURTON
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9019 OVERLOOK BLVD
Mailing Address - Street 2:STE C1A
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-5351
Mailing Address - Country:US
Mailing Address - Phone:615-385-4090
Mailing Address - Fax:
Practice Address - Street 1:2021 CHURCH ST
Practice Address - Street 2:SUITE 800
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203-2021
Practice Address - Country:US
Practice Address - Phone:615-385-4090
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-09-15
Last Update Date:2021-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNP0000002358103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling