Individual provider Active NPI

Kayla Burnett

  • Mental Health Counselor
  • Malvern, AR
National Provider Identifier
1114512522
Registry record updated May 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
P2505012 Issued in AR
Practice address
829 Halbert St
Malvern, AR 72104-2607
Phone
(501) 332-4400
Fax
(501) 332-4403
NPI assigned
Mar 8, 2021
Last updated
May 8, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 8, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X P2505012 AR Primary

Addresses

Primary practice location

829 Halbert St
Malvern, AR 72104-2607

Mailing address

829 Halbert St
Malvern, AR 72104-2607
Phone (501) 332-4400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250515001534 AR Practitioner - Mental Health Counselor 5294253076 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
P2505012ARMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
TFS of Gurdon Inc CurrentSince May 6, 2024 Accepting new patients
Auremelle Counseling Past Accepting new patients

Locations

829 Halbert St
Malvern, AR 72104
Phone (501) 332-4400

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1615161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746662400000",
    "number": "1114512522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "829 HALBERT ST",
            "city": "MALVERN",
            "state": "AR",
            "postal_code": "721042607",
            "telephone_number": "501-332-4400",
            "fax_number": "501-332-4403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "829 HALBERT ST",
            "city": "MALVERN",
            "state": "AR",
            "postal_code": "721042607",
            "telephone_number": "501-332-4400",
            "fax_number": "501-332-4403"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURNETT",
        "first_name": "KAYLA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-03-08",
        "last_updated": "2025-05-08",
        "certification_date": "2025-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "AR",
            "license": "P2505012",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Malvern, AR

Sources for this page

Verify at the official NPI Registry.