Provider Demographics
NPI:1649061045
Name:BURNETT, JOANNA WARD (APC)
Entity type:Individual
Prefix:
First Name:JOANNA
Middle Name:WARD
Last Name:BURNETT
Suffix:
Gender:F
Credentials:APC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:328 ALEXANDER ST SE STE 10
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30060-2092
Mailing Address - Country:US
Mailing Address - Phone:770-425-8275
Mailing Address - Fax:678-302-7461
Practice Address - Street 1:328 ALEXANDER ST SE STE 10
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30060-2092
Practice Address - Country:US
Practice Address - Phone:770-425-8275
Practice Address - Fax:678-302-7461
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-14
Last Update Date:2025-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA009741101YP2500X
GAAPC009741101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional