Provider Demographics
NPI:1720417470
Name:BURNETT, TENA (PHD, LPC)
Entity Type:Individual
Prefix:DR
First Name:TENA
Middle Name:
Last Name:BURNETT
Suffix:
Gender:F
Credentials:PHD, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2751 BUFORD HWY NE
Mailing Address - Street 2:SUITE 700
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30324-3207
Mailing Address - Country:US
Mailing Address - Phone:404-343-1714
Mailing Address - Fax:
Practice Address - Street 1:2751 BUFORD HWY NE
Practice Address - Street 2:SUITE 700
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30324-3207
Practice Address - Country:US
Practice Address - Phone:404-343-1714
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-04
Last Update Date:2016-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC007191101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional