Healthcare Provider Details

I. General information

NPI: 1447592852
Provider Name (Legal Business Name): JENNY LEANN BURKHOLDER PH.D., LMFT, LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/24/2013
Last Update Date: 08/12/2024
Certification Date: 08/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14930 MUESCHKE RD STE 100
CYPRESS TX
77433-0980
US

IV. Provider business mailing address

28652 SHARON LOUISE
MAGNOLIA TX
77355-4611
US

V. Phone/Fax

Practice location:
  • Phone: 346-206-3992
  • Fax: 832-652-3626
Mailing address:
  • Phone: 832-540-0091
  • Fax: 832-652-3626

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number70895
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number201540
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: