Provider Demographics
NPI:1700195377
Name:BURNETTE, SAMMIE F (MS, LPC)
Entity Type:Individual
Prefix:MR
First Name:SAMMIE
Middle Name:F
Last Name:BURNETTE
Suffix:
Gender:M
Credentials:MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1636 ROBIN HOOD DR
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27217-8743
Mailing Address - Country:US
Mailing Address - Phone:336-585-1354
Mailing Address - Fax:
Practice Address - Street 1:1636 ROBIN HOOD DR
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:NC
Practice Address - Zip Code:27217-8743
Practice Address - Country:US
Practice Address - Phone:336-585-1354
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-30
Last Update Date:2010-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1012101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional