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General NPI Number Information
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NPI Number | 1568165488
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Entity Type | Individual
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Provider Name | TIFFANY ANN BURNETTE MT-BC, BCC, CADC-I
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Gender | Female
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Dates
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Enumeration Date | 03/22/2023
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Last Update Date | 06/13/2025
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Provider Practice Location Address
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Address Line | 2172 N SALEM ST STE 105
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City | APEX
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State | NC
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Zip | 27523-6457
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Country | US
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Telephone | 919-629-4360
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Fax | 919-629-4362
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Provider Business Mailing Address
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Address Line | 1312 DALGARVEN DR
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City | APEX
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State | NC
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Zip | 27502-3944
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Country | US
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Telephone | 919-579-9663
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171400000X
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Taxonomy Name | Health & Wellness Coach
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 174H00000X
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Taxonomy Name | Health Educator
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License Number |
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Taxonomy #3
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Taxonomy Code | 225A00000X
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Taxonomy Name | Music Therapist
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License Number |
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Taxonomy #4
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Taxonomy Code | 405300000X
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Taxonomy Name | Prevention Professional
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License Number | CPS-21125
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License Number State | NC
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Taxonomy #5
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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