Healthcare Provider Details

I. General information

NPI: 1578971479
Provider Name (Legal Business Name): KRISTY BURTON LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KRISTY HUFFER

II. Dates (important events)

Enumeration Date: 07/24/2014
Last Update Date: 07/07/2023
Certification Date: 07/07/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2940 W SUNSET AVE STE D
SPRINGDALE AR
72762-4974
US

IV. Provider business mailing address

PO BOX 2129
BENTON AR
72018-2129
US

V. Phone/Fax

Practice location:
  • Phone: 501-205-4570
  • Fax: 888-305-8084
Mailing address:
  • Phone: 501-205-4570
  • Fax: 888-305-8084

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number2022028840
License Number StateMO
# 3
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberP1707327
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: