MEDICARE: JOSHUA PAUL BURNETT M.A.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist	2346	NC

General Provider Information

NPI Number	:	1649410028
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOSHUA PAUL BURNETT M.A.

Provider Business Mailing Address
First Line	:	3315 SPRINGBANK LN STE 106
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28226-3198
Country	:	US
Telephone Number	:	704-916-9578
Fax Number	:	916-609-5161

Provider Business Practice Location Address
First Line	:	3315 SPRINGBANK LN STE 106
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28226-3198
Country	:	US
Telephone Number	:	704-916-9578
Fax Number	:	980-819-5798

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/25/2009
Last Update Date	:	10/16/2024

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