Provider Demographics
NPI:1144746835
Name:BURNETT, REBECCAH SUE (LPC)
Entity type:Individual
Prefix:
First Name:REBECCAH
Middle Name:SUE
Last Name:BURNETT
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 1:423 PROSPECT AVE
Mailing Address - Street 2:
Mailing Address - City:NEPTUNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07753-5629
Mailing Address - Country:US
Mailing Address - Phone:732-823-2128
Mailing Address - Fax:
Practice Address - Street 1:423 PROSPECT AVE
Practice Address - Street 2:
Practice Address - City:NEPTUNE
Practice Address - State:NJ
Practice Address - Zip Code:07753-5629
Practice Address - Country:US
Practice Address - Phone:609-403-0607
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-15
Last Update Date:2024-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00734500101YM0800X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health