Penny Atkins Burnett, LPC – Professional Counselor

Key facts

NPI: 1104133529
Entity type: Individual (NPI type 1)
Primary specialty: Professional Counselor 101YP2500X
License: 1572 (GA)
Practice address: 139 Henry Pkwy
McDonough, GA 30253-6636
Phone: (770) 898-7400
Fax: (770) 898-7412
NPI assigned: Sep 7, 2010
Sex: Female
Sole proprietor: Yes

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): No

State licenses

License	State	Type	Specialty
1572	GA	MD	Professional Counselor

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Professional Counselor	101YP2500X	1572	GA	Yes

Addresses

Primary practice location

139 Henry Pkwy
McDonough, GA 30253-6636

Mailing address

139 Henry Pkwy
McDonough, GA 30253-6636
Phone (770) 898-7400

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Sep 7, 2010.

{
    "created_epoch": "1283817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1283817600000",
    "number": "1104133529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "139 HENRY PKWY",
            "city": "MCDONOUGH",
            "state": "GA",
            "postal_code": "302536636",
            "telephone_number": "770-898-7400",
            "fax_number": "770-898-7412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "139 HENRY PKWY",
            "city": "MCDONOUGH",
            "state": "GA",
            "postal_code": "302536636",
            "telephone_number": "770-898-7400",
            "fax_number": "770-898-7412"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURNETT",
        "first_name": "PENNY",
        "middle_name": "ATKINS",
        "name_prefix": "Mrs.",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-09-07",
        "last_updated": "2010-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "1572",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in McDonough, GA

All providers in McDonough, GA · Professional Counselor in Georgia

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 7, 2010. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.