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NPI Code Detail

MEDICARE: KATHRYN BURNETT, PSYD LLC

MEDICARE: KATHRYN BURNETT, PSYD LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103TB0200XCognitive & Behavioral Psychologist
2103TC2200XClinical Child & Adolescent Psychologist
3103TC0700XClinical Psychologist

General Provider Information

NPI Number : 1386420222
Entity Type Code : Organization
Provider Name (Legal Business Name) : KATHRYN BURNETT, PSYD LLC
Provider Business Mailing Address
First Line : 15630 OLD COLUMBIA ROAD
Second Line : SUITE B 215
City : COLUMBIA
State : MD
Zip : 21046
Country : US
Telephone Number : 204-836-2733
Fax Number : 240-836-2756
Provider Business Practice Location Address
First Line : 10015 OLD COLUMBIA RD STE B215
Second Line :
City : COLUMBIA
State : MD
Zip : 21046-1865
Country : US
Telephone Number : 240-836-2733
Fax Number : 240-836-2756
Authorized Official
Title or Position : DIRECTOR & CLINICAL PSYCHOLOGIST
Name : DR. KATHRYN BURNETT
Credential : PSYD
Telephone Number : 240-836-2733
Provider Enumeration Date : 09/06/2023
Last Update Date : 06/04/2026

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