Healthcare Provider Details

I. General information

NPI: 1790569507
Provider Name (Legal Business Name): LATOYA ARLESIA PHILLIPS-BURKEEN LPC-MHSP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/22/2023
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

660 S MOUNT JULIET RD STE 130
MT JULIET TN
37122-6496
US

IV. Provider business mailing address

660 S MOUNT JULIET RD STE 130
MT JULIET TN
37122-6496
US

V. Phone/Fax

Practice location:
  • Phone: 615-880-8427
  • Fax:
Mailing address:
  • Phone: 615-880-8427
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number6467
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: