Healthcare Provider Details

I. General information

NPI: 1609782234
Provider Name (Legal Business Name): KATE MARIE BURNETT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/22/2026
Last Update Date: 08/22/2026
Certification Date: 08/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1951 PINE HALL RD STE 100
STATE COLLEGE PA
16801-5107
US

IV. Provider business mailing address

10418 RAYSTOWN RD
HUNTINGDON PA
16652-7549
US

V. Phone/Fax

Practice location:
  • Phone: 814-308-8375
  • Fax:
Mailing address:
  • Phone: 814-251-3829
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberAPC002752
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: