Healthcare Provider Details

I. General information

NPI: 1730633199
Provider Name (Legal Business Name): AMY BURNS LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/15/2016
Last Update Date: 02/27/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

211 JACKSON ST SW
CAMDEN AR
71701-3941
US

IV. Provider business mailing address

715 N COLLEGE AVE
EL DORADO AR
71730-4403
US

V. Phone/Fax

Practice location:
  • Phone: 870-836-5743
  • Fax: 870-863-6924
Mailing address:
  • Phone: 870-862-7921
  • Fax: 870-864-2490

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberP1902021
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: