Healthcare Provider Details

I. General information

NPI: 1063336113
Provider Name (Legal Business Name): ROSEMARY AKWELEY BURNS LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/10/2026
Last Update Date: 08/10/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3667 ALTAMA AVE
BRUNSWICK GA
31520-3631
US

IV. Provider business mailing address

1773 JOHNSON RD NE
TOWNSEND GA
31331-9132
US

V. Phone/Fax

Practice location:
  • Phone: 912-577-8821
  • Fax:
Mailing address:
  • Phone: 912-577-8821
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLPC017175
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: