Healthcare Provider Details

I. General information

NPI: 1861207094
Provider Name (Legal Business Name): JULIANA BURNETT LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/13/2025
Last Update Date: 02/13/2025
Certification Date: 02/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2300 DULANEY VALLEY RD STE A
TIMONIUM MD
21093-2700
US

IV. Provider business mailing address

3400 ELGIN AVE
BALTIMORE MD
21216-2604
US

V. Phone/Fax

Practice location:
  • Phone: 667-600-3100
  • Fax:
Mailing address:
  • Phone: 443-987-3143
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License Number24343
License Number StateMD

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: