Provider Demographics
NPI:1710163027
Name:BURNETTE, NENA (LPC)
Entity Type:Individual
Prefix:
First Name:NENA
Middle Name:
Last Name:BURNETTE
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6009 CW POST RD
Mailing Address - Street 2:
Mailing Address - City:JONESBORO
Mailing Address - State:AR
Mailing Address - Zip Code:72401
Mailing Address - Country:US
Mailing Address - Phone:870-932-0228
Mailing Address - Fax:870-910-5689
Practice Address - Street 1:6009 CW POST RD
Practice Address - Street 2:
Practice Address - City:JONESBORO
Practice Address - State:AR
Practice Address - Zip Code:72401
Practice Address - Country:US
Practice Address - Phone:870-932-0228
Practice Address - Fax:870-910-5689
Is Sole Proprietor?:No
Enumeration Date:2008-01-16
Last Update Date:2022-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPO712069101YP2500X
ARP0712069101YP2500X
ARP2005011101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR5A909OtherBCBS