Healthcare Provider Details

I. General information

NPI: 1285810432
Provider Name (Legal Business Name): NEW BEGINNINGS BEHAVIORAL HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/18/2008
Last Update Date: 08/17/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

729 W CENTER CIR SUITE 103
NIXA MO
65714-7001
US

IV. Provider business mailing address

729 W CENTER CIR SUITE 103
NIXA MO
65714-7001
US

V. Phone/Fax

Practice location:
  • Phone: 417-724-0700
  • Fax: 417-724-0710
Mailing address:
  • Phone: 417-724-0700
  • Fax: 417-724-0710

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TH0100X
TaxonomyHealth Service Psychologist
License Number2006029922
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number2004005435
License Number StateMO
# 3
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number2002020631
License Number StateMO
# 4
Primary TaxonomyN
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License Number2002030467
License Number StateMO
# 5
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number2008009366
License Number StateMO

VIII. Authorized Official

Name: DR. KRISTINA DAWN BURTON
Title or Position: OWNER/CLINICAL DIRECTOR
Credential: MSW, PSY.D.
Phone: 417-724-0700